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Low-Tech Telehealth Solutions

Health and Human Services’ Office of Civil Rights (OCR), the entity responsible for enforcing regulations under HIPAA, stated, “effective immediately, it will exercise enforcement discretion and will not impose penalties for HIPAA violations against covered healthcare providers if patients are served on a good faith basis during the COVID-19 nationwide public health emergency.”

The OCR has clarified that, during this public health emergency, these technologies can be used for any services, not only those specific to COVID-19. OCR’s guidance states, “covered healthcare providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules.” Providers should ensure communication products are non-public facing.

The following list is a tool we compiled to demonstrate low-cost and low-tech options to provide virtual telehealth services under the new provisions as outlined by HHS and the Office of Civil Rights.

Web Platform	Key Features
Zoom	All users will need to download the app for all devices except for a laptop/desktop Will need to create an account Easy to start a meeting and join from any device HD Video & Audio Participants can share their screens Meetings are all encrypted, password protection, and attendees can be placed on hold Meetings can be joined directly from calendar invite (participants would just have to click on the link) Screenshare available Quick dial-in option is available in the cases where video is not functioning properly Pricing options: https://zoom.us/pricing Free version of Zoom is available but options are limited, the main one being a time limit of 40 minutes for Zoom meetings Learn more: https://support.zoom.us/hc/en-us
Facebook Messenger Video Chat	All users will need to download the app for all devices Can access on desktop/laptop Available on all devices Must create Facebook account Easy to have the messenger open in one window while typing in another window. Not possible on the smartphone Free for all users Learn more: https://about.fb.com/technologies/messenger/
Google Hangouts Video	All users will need to download the app for all devices Available on all devices For participants who use Chrome, Firefox and Safari this works entirely in the browser Must create Google account Meetings can be setup in advance and links can be shared Video meetings are encrypted Permission must be granted before others can join meetings Meetings can be joined directly from calendar invite (participants would just have to click on the link) Screenshare available Quick dial-in option is available in the cases where video is not functioning properly Learn more: https://support.google.com/hangouts/answer/2944865?hl=en&ref_topic=6386410
Apple Facetime	Available on Apple devices only All participants must have Apple devices Easy to start a call - just enter their phone number or email address Learn more: https://support.apple.com/guide/facetime/welcome/mac
Skype	Available on all devices All users will need to download the app for all devices Must create account HD Video & Audio Live subtitles available Video meetings are encrypted Screenshare available Learn more: https://www.skype.com/en/
No Web Platform	Telephone visits Drive-Thru Visits Office Visits with new process for social distancing. With the increase of telehealth visits, there should be a decrease in patient traffic to the health centers. This should allow for a new process for social distancing.

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Office for Civil Rights (OCR). (2020, March 30). Notification of enforcement discretion for telehealth. Retrieved April 06, 2020, from https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html (Office for Civil Rights (OCR), 2020)