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Using an iPhone for telehealth may seem like a reasonable choice to the casual onlooker. The ease and convenience of using a pocket-held device for one’s clinical work has great appeal. Aside from the Health Insurance Portability and Accountability Act (HIPAA), most Federal and state laws are silent on issues related to your choice of hardware for telehealth. Using an iPhone for telehealth then, is technically allowed. The same is true of many other small, inexpensive digital devices that allow real-time, 2-way interaction.
Reality of Using iPhone for Telehealth
The reality of conducting all of one’s healthcare practice through a small screen poses challenges that most telehealth veterans would avoid, however. Given that the average US mobile phone screen is approximately 5″ x 2,” staying focused on such a small space can create strain, and limit your ability to identify nuances that you would otherwise notice when in-person. On a typical mobile phone, your average patient’s head is likely to appear to be the size of your thumb, or slightly bigger. As discussed our Zoom Fatigue article, using a small screen for too many hours can contribute to potential headaches, eye-strain, neck and back pain.
If assessing a person’s mental status or physical condition is part of your clinical protocol, you most likely will benefit from a larger screen. The good news is that getting a large screen to connect with your small device can be as simple as connecting to a television. You can simply get a cable and connector to plug your device a Smart TV anywhere, assuming that you can find a private space, a professional-looking background and enough bandwidth to maintain a reliable connection.
Using a Television as Your Telehealth Monitor
Most of us occasionally make life-and-death decisions based on the information we can gather through our telehealth screens. Maximizing screen size then, makes sense. As far as telehealth video screens go, bigger is often better. A 42, 52 or bigger screen will allow you to see nuances that you clearly would miss when using the small screen from your iPhone for telehealth. In using a TV for a monitor, your room set-up may need to be altered. Most TVs are not made for viewing up-close. You may want to be seated 6-10 feet or more away from the larger screen for comfortable viewing.
How to Use a Smart TV with Your iPhone for Telehealth
Smart TVs have been around for many years, which means they are relatively easy and inexpensive to find if you don’t already have one. They offer integrated Internet and interactive Web 2.0 features that allow you to stream music and videos, browse the internet, and view photos. Connecting your iPhone, laptop, iPad, another tablet, or even a desktop to a large Smart TV screen can be done in two ways – with a cable (wired) or without a cable (wirelessly).
Wired iPhone for Telehealth
The most stable way to connect your iPhone to a TV is “wired.” To do this, you need two important cables: a Lightning Digital AV Adapter and High-Speed HDMI Cable. You will also need a Smart TV.
The Lightning Digital AV Adapter will enable you to connect your iPhone to your TV via the HDMI cable. You can buy this adapter and see the list of all the compatible iPhone models with it here.
The High- Speed HDMI cable will connect your TV to your phone via the Lightning Digital AV Adapter. It is practical to get a longer cable so you can run it from the back of your TV to your iPhone.
- a) Connect one end of the HDMI cable to a vacant HDMI port on your TV. You can find the HDMI ports either on the sides or behind your TV. Ports for HDMI have labels on them. Note the number of the port.
- b) Connect the other end of the HDMI cable to the Lightning Digital AV Adapter.
- c) Connect the Lightning Digital AV Adapter to your iPhone. You will see that there is also a charging port in the Lightning Digital AV Adapter. The charging port is beside the HDMI cable port. This will enable you to charge your iPhone in case your battery runs low.
- d) Turn on your TV. Use your TV’s remote or TV’s controls to switch to the correct HDMI port that you’ve plugged the cable into.
- e) The TV will then show what’s on your iPhone’s screen.
- f) You now have set-up your iPhone for telehealth appointments.
Wireless Use of an iPhone for Telehealth*
To go wireless, software called AirPlay can be downloaded onto your iPhone through an app from the App Store. That app will project the contents of your iPhone screen to your television screen. Airplay works to connect an iPhone to an Apple TV. Verify that both your iPhone and Apple TV have an up-to-date operating system and set up a password to prevent unauthorized streaming. When choosing alternatives to Airplay for iPhones or Android phones, be sure to set up an AirPlay password or by restricting devices in a different network to connect to the TV being used in your practice AirPlay security settings can be configured on an Apple TV running tvOS 11 or later. Click here to see the complete list of TV brands that support AirPlay.
Confirm that your iPhone is linked to the same Wi-Fi network as the Apple TV. It will not work if they have different Wi-Fi connections.
Swipe down the Action Center from the top right of your iPhone. This is the case for those iPhone models that enable face identification. For other iPhone models, you need to swipe up from the bottom of your phone screen.
Tap Screen Mirroring.
Your Apple TV name will appear in the list. Tap that. Now, you will see your phone screen being projected to the Apple TV.
Log into your video session from your iPhone.
Relax and proceed as usual.
Follow this flow: HDMI cable plugs into TV HDMI port; the other end of HDMI cable plugs into the Lightning Adapter; the Lightning Adapter plugs into the iPhone.
TV —> HDMI —> Lightning Adapter —> Security Settings (Password) —>iPhone for telehealth
Concerned about HIPAA and Using Your iPhone for Telehealth?
For more HIPAA details about using your iPhone or Android phone for telehealth, see HIPAA Compliant Telehealth and Apple AirPlay.
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I appreciate the responses. Without some plan to face the camera, the therapist will seem to be distracted, maybe watching videos while the client is talking.
In your iPhone instructions it appears that you have only addressed the display on which you see the client. The iPhone also serves as the provider’s camera, unless there is another camera hooked up to the system. So I would like to see you talk about how to look in the direction of the camera, etc. when the client’s image is displayed on another device.
Thank you for your excellent question. The best workaround I’ve seen is for a clinician to have the TV screen about 6-12 feet away from their desk chair, with the iPhone position on a tripod between them and the TV screen. That way, when you are looking at the TV, your client or patient will have the sense that you are looking at them because you are clearly looking in their direction.
I don’t have a photo but can draw it in 2-dimensional space like this:
YOU iPhone on tripod TV Screen
That also allows you to put sufficient lighting in front of you on either side of the tripod, but off to the side so as to minimally obstruct your view of your client/patient as it is projected onto the TV behind your iPhone and tripod. You will have to experiment with distances so as to minimize the level of obstruction that you experience.
Thank you for your excellent question.Your concern is valid. The best arrangement that I’ve seen is to have the TV screen be a fair distance, removed from the end of your desk by several feet. The distance should be proportional to the size of your TV monitor, with more distance added for larger monitors. The iPhone then can be mounted on a tripod, positioned between you and the TV. Hardware for such mounts can be found at Amazon or in photography stores.
I don’t have an image to demonstrate what I’m referencing, but I can draw it in two-dimensional space here, (and I can ask that if anyone has an image that they can provide for us to add to the article, please send it to us by email). Here is the 2-dimensional drawing:
YOU——————->IPHONE on TRIPOD ——————- TV
The next issue to minimize is obstruction of your view caused by the iPhone. There again, you will need to vary the height of the tripod and distances so that your client/patient will see the end of the desk, but nothing more of the space between you and the camera. Lastly, you may want to add some photography lights on either side of yourself, facing you but off-camera. While such a room cannot quickly be converted to a normal room in a home, it does provide maximum viewing comfort at a very low cost. For a microphone, you can experiment with using earbuds with a longer than usual cord. A quick check on Amazon.com pulled up earbuds that are 6 feet and 12 varieties.
I encourage others to contribute to this conversation. This is one case where creativity reigns supreme. There are many “right” ways to set up your virtual office so as to be seated comfortably, view maximally and yet relax while working from home – or wherever you prefer.
Best article on using a iPhone for TeleHealth with how to info.
Thanks. Will pass it along and let folks know about the TeleBehavioral Health Institute.
Thank you, John. Your spreading the word about our work is much appreciated.