The California Telehealth Network  Is Approved Federal and state government and medical officials have officially announced the approval of the California Telehealth Network (CTN). It is the US’ largest effort to provide broadband-based specialty care in medically underserved rural and urban areas.

The $30 million project, co-funded by the Federal Communications Commission’s Rural Health Care Pilot Program, and public and private sources, will connect more than 800 California clinics and hospitals to a statewide medical-grade network of healthcare and emergency services by 2013.

The peer-to-peer network will enable providers to share X-rays and other diagnostic tests instantly, and view treatments and procedures from afar in long-distance emergency rooms or surgical centers in real-time, according to Sandra Shewry, president and chief executive officer of the Center for Connected Health Policy. The CTN will also link to 68 other networks in the nation and serve as a model for other networks as they are funded and come on board, according to state officials.

Gov. Arnold Schwarzenegger called it “a new era for healthcare… the beginning of a new digital highway that will fundamentally change the future of how healthcare is provided.” Full Story Further Information

Join us for an informal gathering, the "Telepsychology Cocktail Hour," Friday evening, August 13th. It will between 6-8 PM at the SD downtown Marriott, North Tower, Lobby Lounge, Lobby Level. (It is one of two big twin-tower hotels next to the convention center.)

Anyone interested in telehealth, remote care, online counseling, online therapy, virtual reality, or any other technology-mediated treatment/research is welcomed. This party will be a networking event, and for some of us, a long-awaited reunion!   

• Please confirm by emailing me at <drm@telementalhealth.com> so we can reserve adequate space in this popular lounge area.

1. LET US KNOW ABOUT YOUR WORK, TOO: If you are delivering other telepsychology-related presentations at APA, or are currently working in the telepsychology field, bring flyers or details of your work to the Friday evening reunion. 2. FULL  DAY, APA Continuing Education PROGRAM: Consider attending a hands-on, interactive telepsychology CE workshop, Sunday of the convention (August 15).  See this APA flyer. 3. SHORTER TELEPSYCHOLOGY PROGRAMS: Click here for details of  my other telemental health and online therapy activities at APA. These are available for no additional fee if you attend the convention.

Here's another unofficial guide for your San Diego visiting pleasure during the upcoming APA convention.  (See my earlier blog for a restaurant guide.)

Local Attractions:

Most people have probably heard of San Diego Zoo, restaurants, will District, city tours…but these below are some of the  gems that I offer my own out-of-town guests:

1. Best activities within walking distance (or very nearby) are:

Best Leisurely Walks:

• A stroll along the marina, going left (east), behind the convention center along the marina. Walkway leads to a park, where you can enjoy the view.
• Go to the right of the convention center (west) along the marina and you will bump into Seaport Village, where you can pay exorbitant fees, but can shop in fun boutiques. You also will see a horse-dawn buggy ride offered here, but only if you ask for the longer tour. Short one takes you up the street and back, and is a rip-off.

Nearest Mall:

• Horton Center: right up Fifth Avenue from the convention center. Huge outdoor mall.

Nearest Large Grocery Store:

• Ralph's: http://sandiego.citysearch.com/profile/444265/san_diego_ca/ralphs.html

Harbor Cruises:

• If you like being out on the water, book a seat on the Harbor Excursion. It takes you along the coast and is really worth a few hours of time. Boat has shaded areas as well as sunny. http://www.sandiegotours.us/?event=offer.type&productType=CRUISE&mpt=98&name=Cruises%20in%20San%20Diego

1. Live Music:

• Open Air  Local Music Venue within walking/taxi distance to Convention Center:http://humphreysconcerts.com/schedule_glance.cfm (on the marina – windy and chilly but waaay fun)
• Outdoor Symphony (on the Harbor) within walking distance from Convention Center (maybe a mile): http://www.sandiegosymphony.com/calendar_index.php?month=8&year=2010 Also a bit windy/chilly, but the view at sunset is incredible.

1. San Diego Baseball:

PetCo Park is home to the Padres. This venue is new and across the street (ok, it' s really wide street, with a few other little ones along the way) from the convention center http://mlb.mlb.com/sd/ballpark/index.jsp Our only home game between August 12-15 is during our EC meeting, but hey, your family might like to go.

1. Balboa park has many museums, theatres, etc. Large green areas. It is just north of downtown, approx 5-10 minutes from the convention center by cab. http://www.sandiego.com/attractions/balboa-park

2. Local theater groups and other live performance venues are quite good.

• http://www.sandiego.com/attractions
• http://www.san-diego-attractions.10-best.info/
• http://www.sandiego.org/nav/Visitors/EventCalendar
• http://www.tripadvisor.com/Attractions-g60750-Activities-San_Diego_California.html

1. If you have a car, go north (the further north you go, the more gentrified the area, until you get past Del Mar):

1. Old Town – Mexican influence is unique and vibrant, shops, restaurants, music
2. Coronado Island (Hotel Del Coronado – beautiful older hotel famous for movies, beach with great westerly views)
3. http://www.hoteldel.com/?src=ppc_google_brand1&phonalytics=Mjg0NnwxICg4ODgpIDMyNyAtIDA5MTk&s_kwcid=TC|19392|hotel%20del%20coronado||S||5881610944
4. Point Loma (lighthouse and park are quite interesting and educational)
5. Ocean Beach (beach types, smoke shops, hippies are quite visible – long pier goes into ocean, Sunset cliffs)
6. Mission Beach/ Pacific Beach (a bit nicer and beach is awesome but walkway is crowded and could be dangerous if you don't move quickly because skate boarders and bikers whiz by in on sidewalk, but has surf areas and swimming is great, with flat beach that goes for miles)
7. La Jolla coastal walk along the "Cove" (snorkeling/diving in an underwater park, 2 separate nesting ground for native seals at the Cove and a much bigger seal nesting ground one at the "Children's Pool." Also at the cove, you'll find ocean caves, kayak tours, and up above, boutiques galore and restaurants with views of the cove and facing cliffs that light up at sunset)
8. La Jolla Shores (flat swimming beach with lifeguards, showers, relatively calm waters)
9. Coastal drive between La Jolla and Del Mar has a few really fun spots:
   • Hand Gliding Port http://flytorrey.com/cms/
   • Scripps Institute of Oceanography – relatively new aquariums are beautiful http://scripps.ucsd.edu/
   • Torry Pines Golf Course – world class golf - http://www.torreypinesgolfcourse.com/
   • Torry Pines State National Reserve – my favorite hiking trails county-wide. Views from cliffs over the Pacific ocean are breathtaking and ever-changing. Various levels of difficulty for hiking, from flat trails to climbing down the cliffs to the beach. Good swimming beach with lifeguards at base of the trails – but rip-tides are common.  http://www.torreypine.org/parks/trails.html
10. Del Mar (race track http://www.dmtc.com/ and indescribable balloon rides at sunset in Del Mar over local mansions).
11. Wild Animal Park (even better than the zoo, IMHO if you don't mind driving inland where it can get hot)
12. State Parks are pretty much the same  –> get better and better as you go north. Comfort stations are available in just about any state park.

1. If you are traveling with your family or prefer safety, you might want to keep away from going EAST and SOUTH of the convention center, in general.  Why? Crime is much more rampant.

Mexico

You might want to stay away from Tijuana or even further south down the coast in Mexico. No matter what the tourism board reports, it isn't worth it. Local news reports continue to show how crime and local police controversies make northern Baja Mexico a place to avoid right now.

• Drug money has empowered gangs beyond anything the Mexican government seems able to control. Criminals are successfully coming over the border to southern areas of San Diego county. In general, the eastern and southern SD county area is not a place to get lost – dangerous if you are in the wrong place at the wrong time.

Zip code downtown is 92101 – so just stay North and West to be the safest.  Then again, if you like more than the average amount of adventure, head East and South.

1. Weather:

Check weather predictions before you pack. San Diego has been unusually chilly this summer. As of today, we're still  walking around with jackets or layers at night: http://www.weather.com/

During the day, the weather is awesome – so bring the sunscreen!

Bring a blanket if you decide to catch an outdoor concert or watch the sunset over the water.

And come to my various telepsychology programs at APA to get a glimpse of the future of clinical work, research and psycho-education. See here: http://budurl.com/73a4

Enjoy!!

Marlene Marlene M. Maheu, Ph.D. is the Executive Director of the TeleMental Health Institute, offering CEU programs related to the practice of online counseling, online therapy and telepsychology.  Academic books authored by Dr. Maheu  include eHealth, Telehealth and Telemedicine and The Mental Health Professional & the New Technologies.

As a San Diego resident, I feel it is my "duty" as a psychologist to give you my personal choices for downtown San Diego dining.  These memorable restaurants are within reasonable walking distance from the San Diego Convention Center.

1. Oceanaire or Blue Point for Seafood
2. Bice (we love), Acqua Al 2, or Salvatores (another favorite but old school)  for Italian
3. Red Pearl (Asian mix)
4. Monsoon or Masala for Indian
5. Cafe Chole for Bistro French
6. Rama for Thai
7. Candelas or El Vitral for upscale Mexican (LOVE their vegetarian tacos)
8. Morton's is great for both beef lovers and vegetarians because their side orders are awesome.
9. Flemings is good choice  for beef lovers as well!

Bon Apetit! Marlene M. Maheu, Ph.D. is the Executive Director of the TeleMental Health Institute, offering CEU programs related to the practice of online counseling, online therapy and telepsychology.  Academic books authored by Dr. Maheu  include eHealth, Telehealth and Telemedicine and The Mental Health Professional & the New Technologies.

Are you confused about what to do when a new patient “texts” you on your cell phone? Not sure what you need to document in your psychotherapy notes? What are your other legal requirements with respect to informed consent?

See this new article for related concerns, considerations and potential solutions. This article contains a discussion of 3 short vignettes about these and several more texting issues.

Please post your comment below!

Marlene M. Maheu, Ph.D.

Executive Director, Center for Online Counseling

Join me at August 2010 APA Convention!

See  presentation schedule (4 public presentations).

Members of the American Telemedicine Association’s (ATA) telemedicine health special interest groups (SIG) have laudably published a number of “Best Practices” or “Guideline” documents, such such as for telemental health. These guidelines however, expressly exclude practice via the Internet.

Solo and independent practitioners face a different set of challenges than our institutional colleagues.

As small business owners (in essence), we operate with fewer layers of protection from liability and with less oversight by supervisors.  We typically work in small offices, free from the same adherence to either treatment or practice protocols as might exist when working in academic, government or other large institutional settings.

We therefore have somewhat different experiences – and risks. It is my opinion then, that those differences with respect to telemental health warrant attention by those associations who accept our yearly dues and set standards  for us as a group.

Aside from documents issued by the National Board of Certified Counselors (NBCC) and the International Society for Mental Health Online (ISMHO), two relatively small groups that paralleled each other in strongly advocating the use of e-mail and chat rooms to work with unseen, previously unknown and undiagnosed mental health clients or patients, I have awareness of one formally produced document that addresses the myriad complexities of remote ethical practice for solo practitioners in the United States. That document is the “Telepsychology Guidelines” produced by the Ohio Psychological Association, originally published in 2008.

Since then, most of us have witnessed the rapid proliferation of services such as Skype-type videoconferencing services on the Internet, cell phone use and texting, and have heard of colleagues who use these services. Unfortunately, many of those practitioners seem to be jumping on the new technologies without training in ethical or legal vulnerabilities with respect to consumer protection or their own risk management.

Therefore, I have these question for you, my resourceful colleagues:

1. Are you aware of any other statements, ethical decisions, announcements or other documents for  independent practitioners seeking guidance for practice through the Internet as produced by any of the large US professional associations?

2. Do you live in a country other than the US, and have a professional association that has published such a document?

If you are aware of any such resources, please leave links or details in the comments section below.

Internet-based self-help information and tools are already far surpassing the number of people getting professional mental health services.

The stance that self-help will outpace clinical work is one I made 15 years ago when I set up SelfhelpMagazine. The Net has already proven me right, with the proliferation of countless self-help websites and online services in just 1.5 decades. If you look at their traffic worldwide, the numbers are staggering.

What’s the next generation of telecommunication development going to bring? Mobile apps.

How can I say such a thing?

See my earlier blog post called, The Future of Healthcare is Mobile? Web stats already show that mobile is growing far faster than desktop programs – in fact it will soon surpass desktop in usage. People want convenience, and there’s nothing more convenient (to date) than having unlimited information access in one’s hip pocket.

Examples For a glimpse into the existing world of mobile phone apps specifically designed for mental health functions as opposed to the general area of personal growth or self improvement, see this article in yesterday’s The Independent. Conclusion Mobile, digital self-help is likely to soon outweigh what is happening on websites.  Once mobile apps get developed, these free or low cost (typically $.99 – $4.99)  self-help tools  will be used far more than professional clinical services or self-help self-monitoring and other basic therapy techniques. Identification of negative self-thoughts is a good example of how such an app can be developed to augment tradtional cognitive behavioral therapy for depression,  anxiety or any of the personality disorders. They might also help coaches assist their clients with homework of other types. In essence then, mobile apps can be sued to help the patient or client with various types of homework, and then brought by the client or patient to their treating professional for discussion. As telecommunication technologies develop, the  trained mental health practitioner will need to adapt to a world where consumers prefer to use their mobile devices to identify and track some their own behavior, with or without the guidance of professionals. Once data has been gathered, trained professionals will have a key role as specialists who can take the data gathered and help the client integrate it into higher orders of functioning. Clinicians, then will become more specialized. Mobile apps and other services available through desk-top computers will replace some of the more common, basic functions currently being served by the licensed professionals of today. That’s my opinion. Now please let me know what you think. Marlene M. Maheu, Ph.D.