Virtual Consult Best Practices for Lactation Consultants
While most clinicians can agree that nothing can replace an in-person lactation consult with a family in need of help feeding their baby, virtual consults are becoming more and more popular as a way to make services more accessible. In order to meet your ethical obligations and stay within your scope of practice as an IBCLC or other lactation credential, you’ll want to keep some key factors in mind.
Create your virtual offers
First, you’ll want to decide what services you feel capable of offering in a virtual setting.
You love teaching prenatal classes, or doing back-to-work consults, and don’t want to have to either charge a full consult fee or give up a consult slot for a lower compensating service.
You have a specialized niche within the lactation field, where you offer expertise that can be hard to find.
You have a personal connection with a type of client who may not have access to in-person lactation services.
You’re looking to expand your follow up offerings for existing clients.
Set clearly defined client expectations
With virtual health, it’s critical to make sure that the potential client understands exactly what to expect. That means more than telling them what you can do for them—it also means making sure they understand any limitations that would apply so that they can prepare.
For example, you may want them to rent a scale (like the ones listed here) that is sensitive enough to do pre- and post-feed weights, or set the expectation that a weighted feed won't be possible.
You’ll want to guide them on how to position their camera and what kind of lighting they should have so that you can see what you need to see.
If you’re offering a class or counseling session without a clinical component, make that clear before they purchase or schedule so that there are no miscommunications about what will happen during your time together.
Work within your scope of practice
If you’re an IBCLC, you have three documents that define how you can work with clients:
As you develop your virtual offerings, you’ll want to make sure they’re aligned not only with what is allowed in the scope of practice, but what is possible for you in a virtual context. Ask yourself these two questions:
Am I offering a service that I am clinically trained and certified to provide?
Do I feel that I can ethically perform this service in a virtual setting?
It’s more than just what you’re trained to do, but about your ability to translate those skills into a virtual setting. You’ll need to modify how you organize the consult, what questions you ask your clients, and how you frame your recommendations. In a virtual setting, you don’t have full access to all of your senses the way you do in-person, and you may find that affects the level of assessment and instruction you can provide your clients.
Know your legal and ethical obligations
In many countries, virtual healthcare (also known as telehealth or telemedicine) has limitations based on legislation for online privacy. In the US, that’s HIPAA; in Canada, you’re talking about PIPEDA; in Australia your clients have rights under the Privacy Act; and in the European Union you’ve got to know the ins and outs of the GDPR. If you’re providing care across international borders, you may need to comply not only with your own country’s legislation, but with the legislation of the country where your client resides. (Here’s a super deep dive into GDPR implications for cross-border care.)
The IBLCE Code of Professional Conduct requires that IBCLCs protect patient privacy which means that should be complying with applicable local laws. Furthermore, our ethical code mandates that we take a perspective on privacy that isn’t about finding loopholes but about seeking to make protecting client privacy a priority in our systems and policies.
This means implementing a tech solution for virtual consults that promises the appropriate level of privacy protection. In the US, this means staying away from FaceTime and Skype because they don’t comply with HIPAA regulations.
One of the most affordable solutions for virtual care is G-Suite Meet, which is bundled with a paid G-Suite account that’s configured for privacy compliance. So if you’re already using G-Suite for email, Meet will mean not paying anything extra. This comparison chart provides a rundown of other communications solutions that offer telehealth features.
Virtual consults can be a great option for both clinicians and families, offering care solutions that can meet a variety of needs. By implementing these best practices (which can go in your policies and procedures manual), you can meet your ethical obligations and deliver outstanding clinical care.
ABOUT THE AUTHOR
Annie Frisbie, MA, IBCLC is the creator of the Lactation Private Practice Essential Toolkit, a collection of books, resources, legal forms, training manuals, and workbooks designed to help private practice lactation consultants build a private practice that’s ethical, profitable, sustainable, and enjoyable.
In 2018 she was honored with the US Lactation Consultant Association's President's Award. Through her popular blog, online store, podcast, and one-on-one coaching, Annie has helped thousands of lactation consultants grow their businesses with simple systems that make their lives feel easier and more joyful!