Do all telepsych companies allow psychiatrists to use their cell phone to do visits?

[B52slinger]

The one I'm currently working for does allow psychiatrists to do cell phone visits which I find very convenient. Do all companies allow this? (just wondering in case I end up switching companies)

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[rjs2131]

Cell phone as in audio only? This isn't common and is probably below standard-of-care (you also wouldn't be reimbursed via insurance for this in the same way - at least where I practice, a "telephone" visit pays significantly less than a video visit).

If you're asking about using an iPhone to do a video visit...that should be fine and happens all the time (more so on the patient side, but I've used doximity on occasion if there are tech issues with the laptop/computer).

 

[calvnandhobbs68]

Yeah same as above most insurance companies will not reimburse for audio only visits anymore, they typically specifically define telemedicine as "audio/video" and you should have a blurb stating in your note that the visit was conducted with a synchronous audio/video HIPAA compliant system.

I've seen in facebook groups before that insurance companies have gone as far as requesting telemedicine records to make sure you actually were doing video calls for the length of time stated.

 

[B52slinger]

I'm referring to video visits by smartphone, to clarify.

 

[comp1]

If the app runs on the smart phone, why wouldn't they?

 

[calvnandhobbs68]

So you're asking us if ALL telemedicine companies allow people to use their personal devices instead of company issued devices or something for telemed visits?

Idk man interview with a couple and ask, how would we know that?

 

[psycho-matic]

I use my personal computer for telehealth visits. I wouldn't use my phone - that's just tacky. Hard to get a good image on a phone that isn't wobbly. Not to mention, I type while on the video call. I will sometimes call the patient if there's audio problems or poor connectivity, but I do this from a desktop, HIPAA-compliant virtual phone software and keep my camera view on. I've never heard of someone using their cell phone for patient encounters.

 

[Stagg737]

I use my personal computer for telehealth visits. I wouldn't use my phone - that's just tacky. Hard to get a good image on a phone that isn't wobbly. Not to mention, I type while on the video call. I will sometimes call the patient if there's audio problems or poor connectivity, but I do this from a desktop, HIPAA-compliant virtual phone software and keep my camera view on. I've never heard of someone using their cell phone for patient encounters.

I use my cell phone when I have my telehealth clinic at home during admin weeks. My computer screen is too small to get a decent video AND have our EMR open. I use an anchored phone holder and patients don't know the difference. All devices that use our academic center's EMR (including phones) have to have applications and software registered and approved through our IT, so it's HIPAA compliant and secure as long as we're using their apps. Honestly, my iPhone's camera and sound are better than both my personal computer and my office at work, patients have actually commented on how much better the connection and picture are on my phone.

 

[psycho-matic]

I use my cell phone when I have my telehealth clinic at home during admin weeks. My computer screen is too small to get a decent video AND have our EMR open. I use an anchored phone holder and patients don't know the difference. All devices that use our academic center's EMR (including phones) have to have applications and software registered and approved through our IT, so it's HIPAA compliant and secure as long as we're using their apps. Honestly, my iPhone's camera and sound are better than both my personal computer and my office at work, patients have actually commented on how much better the connection and picture are on my phone.

Honesty, investing in a large monitor, good webcam, fast computer and high speed internet would solve those problems. No need to be cheap on a psychiatrist's salary. I easily have 3.5k invested in my equipment (all tax deductible) and fiberoptic internet is inexpensive these days.

 

[Atreides]

Honesty, investing in a large monitor, good webcam, fast computer and high speed internet would solve those problems. No need to be cheap on a psychiatrist's salary. I easily have 3.5k invested in my equipment (all tax deductible) and fiberoptic internet is inexpensive these days.

No webcam you’ll buy will be better than an iPhone’s camera. You need to get to DSLR before you get better quality. If you have a MacBook and iPhone, I wouldn’t spend money on a webcam. I’m sure there’re “phone as webcam” equivalents for Android/PC too.

 

[Stagg737]

Honesty, investing in a large monitor, good webcam, fast computer and high speed internet would solve those problems. No need to be cheap on a psychiatrist's salary. I easily have 3.5k invested in my equipment (all tax deductible) and fiberoptic internet is inexpensive these days.

Yea, I’m not dropping $3k+ on equipment for 4-6 hours/month of work. We have Fiber at home for internet, so that’s not the issue either. I’m sure that’s part of why the experience is better on my phone at my house than it is at work. Plus I can easily adjust the phone stand for a better angle and it cost me all of $40. If my patients feel like it’s a better experience, why should it matter if it’s my phone or a full monitor?

ETA: If anyone ever offers to take over the clinic I’ll be gone yesterday. So no reason to drop that kind of money on a setup I may never use again in 6 months.

 

[psycho-matic]

No webcam you’ll buy will be better than an iPhone’s camera. You need to get to DSLR before you get better quality. If you have a MacBook and iPhone, I wouldn’t spend money on a webcam. I’m sure there’re “phone as webcam” equivalents for Android/PC too.

Each to his own. I like my Logitech 4k webcam.

 

[psycho-matic]

Yea, I’m not dropping $3k+ on equipment for 4-6 hours/month of work. We have Fiber at home for internet, so that’s not the issue either. I’m sure that’s part of why the experience is better on my phone at my house than it is at work. Plus I can easily adjust the phone stand for a better angle and it cost me all of $40. If my patients feel like it’s a better experience, why should it matter if it’s my phone or a full monitor?

ETA: If anyone ever offers to take over the clinic I’ll be gone yesterday. So no reason to drop that kind of money on a setup I may never use again in 6 months.

Fair point. I work 30-40 hours/week telehealth from home.

 

[B52slinger]

Fair point. I work 30-40 hours/week telehealth from home.

and with your company it would be forbidden/impossible to use your cell phone for video visits?

 

[psycho-matic]

and with your company it would be forbidden/impossible to use your cell phone for video visits?

No, not forbidden. I've just never heard of someone doing it.

 

[Merovinge]

No, not forbidden. I've just never heard of someone doing it.

FWIW I know a number of private practice docs who do significant televisits and have never heard of it either. The aspect ratio is different on phones compared to webcames from what I have experienced. If someone knows you are using a phone for the video/camera but also working on a laptop that seems reasonable. If you are on the beach on your phone it would be a very different experience 🤣.

 

[mistafab]

There are 20 dollar webcams these days that can broadcast at HD levels.

Phone can be fine but picture wobble can be intrusive. A simple stand could make that go away. I find a rooted webcam at a docking station just makes my life easier. The setup is like 100-300 dollars tops (docking station, webcam, monitor) and can be used for everything. The one negative is most built in microphones (phone, webcam, laptop) are poor audio quality or have inconsistent sound. Again, a 20-dollar dedicated desk microphone makes that moot.

From the perspective of the patient - If I am using my own phone to speak with my doctor who is also using a phone - the audio can get choppy. If on the doc's end the audio is decent enough, that makes the patient experience much better.

 

[Stagg737]

Fair point. I work 30-40 hours/week telehealth from home.

If someone was doing telehealth as their FT gig or any significant amount of time where they're in one office, then I'd agree it would definitely be worth it to drop some money on a nice set up. I did think about spending some CME money on an iPad recently to use for my few telehealth appointments and I still might. I don't want to buy more expesive equipment exclusively for telehealth when it's so little of what I do though.

Also, for some people where they do telehealth from multiple locations or may "double dip" and do telehealth while working another job (see telehealth patients from the inpatient unit in the afternoons, going from unit to unit, etc) using a cell phone makes it easier to do multiple jobs and be more mobile.

 

[Atreides]

Just to clarify, when I say use your phone as a webcam, I mean with a mount, something like this. No wobble or anything. I do have a dedicated condenser microphone that I use as well.

 

[Psychferlyfe3000]

That sounds incredibly unpleasant, imo. I need big screen dual monitors, baby!

 

[Atreides]

That sounds incredibly unpleasant, imo. I need big screen dual monitors, baby!

Huh?