Recording Telehealth Sessions?


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Should clinicians make telehealth therapy session recordings?

Telehealth experts all too often tell stories about how therapy session recordings or documents get into the wrong hands. As licensed professionals, we each have to decide how to handle the issue of telehealth recording, given our respective clients/patients and interventions.

Greater Potential for Loss of Control with Recording Telehealth

Since 1959 when telebehavioral health, telemental health (also known as behavioral telehealth) research began, the best practice has been to avoid recording a session unless it is court ordered — or if the recording is secured and serves a specific purpose that is agreed to by both parties (i.e, hypnosis, supervision).

All in-person principles related to recording apply to telepractice, except that using technology adds greater potentials for loss of control and wider dissemination of recordings.

Professionals can lose or misplace their own therapy session recordings. Storing recordings to the “cloud” can pose unexpected problems as well because most automatic computer cloud storage system are not HIPAA-compliant. You automatic settings then, can be uploading all your recordings, correspondence and other saved files to the unsecured cloud on a weekly or daily basis without your direct knowledge.

We simply can’t predict with any accuracy where they might go over time if we have not sought specific training in how to assure confidentiality (i.e, HIPAA-compliant storage processes and services if you practice with U.S. residents, or PIPEDA if you serve Canadian clients/patients.) Many other countries have such privacy and/or security laws.  In general, the legal places to record anything from your computer include: 1) a HIPAA-compliant cloud, 2). a thumb drive or 3) a backup system in your brick-and-mortar office, and 4) an online video provider that you have vetted very carefully, and from whom you have obtained a valid Business Associate Agreement (BAA) to protect both your clients/patients and yourself.

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