March 20, 2020 —
R 201727 MAR 20
FM COMDT COGARD WASHINGTON DC//CG-11//
TO ALCOAST UNCLAS//N06300//
SUBJ: TEMPORARY CHANGES TO TELEMEDICINE POLICY IN RESPONSE TO THE COVID-19 PUBLIC HEALTH EMERGENCY
A. Health and Human Services Notification of Enforcement Discretion for Telehealth Remote Communications During the COVID-19 Nationwide Public Health Emergency dtd 17 Mar 20
B. Telemedicine, COMDTINST 6300.3 (series)
C. Use of Imaging and Recording Devices in USCG Healthcare Facilities, COMDTINST 6010.6 (series)
1. This ACN provides guidance on the use of popular video chat applications to deliver healthcare services ("telehealth") during the COVID-19 public health emergency. REF (A) waives Health Insurance Portability and Accountability Act (HIPAA) restrictions against using non-public facing remote communication products, such as FaceTime or Skype, to communicate with patients during the COVID-19 outbreak.
2. REF (B) allows USCG medical personnel to deliver clinical services via video teleconferencing (VTC), but requires that VTC platforms be HIPAA compliant. REF (C) prohibits USCG healthcare personnel from using personally owned devices to take images or make recordings of patients, or to otherwise facilitate any other communication or conveyance of protected health information (PHI) in the healthcare context.
3. The prohibitions in Chapter 13 of REF (B) and Chapter 11.a. of REF (C) against using personally owned devices to deliver telehealth services are hereby temporarily waived, but this temporary waiver shall apply only to video and audio functions for the purposes of patient encounters and continues to follow the other guidelines outlined in REFs (B) and (C). Use of screen shots, capturing video or audio of the medical examination, or recording of any audio or video content of the medical interview is prohibited and subject to penalties under REF (C).
4. In accordance with HHS COVID-19 guidance in REF (A), USCG healthcare may use the following VTC products to deliver telehealth services without a Business Associate Agreement (BAA): Skype for Business, Updox, VSee, Zoom for Healthcare, Doxy.me, Google G Suite Hangouts Meet. Personnel may also use the following non-HIPAA compliant private facing applications to deliver telehealth services during the COVID-19 national public health emergency: Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype (preferred).
5. Personnel shall not use public facing applications, such as Facebook Live, Twitch, and TikTok.
6. The temporary waiver to use personal devices and non-HIPAA compliant video chat systems is only valid while REF (A) remains in effect.
7. HSWL-SC will distribute additional telehealth guidelines to the field.
8. Technical point of contact: CAPT Joseph L. Perez, Chief, Operational Medicine, HSWL Service Center, 757-628-4338, firstname.lastname@example.org.
9. Legal point of contact: LT Guyer S. Bogen, Legal Service Command Norfolk, VA, 757-628-4435, Guyer.S.Bogen@uscg.mil.
10. RADM Dana L. Thomas, Direct of Health, Safety, and Work-Life, sends.
11. Internet release is authorized.