Internet Interrupted: Preparing for and Handling Tech Issues in Telehealth

Vol. 1, No. 7 | June 7, 2024 | By Dave Larsen, Väsentlig Consulting LLC

As a solo mental health practitioner providing telehealth services, your internet connection is the lifeline that enables you to connect with and support your clients. However, even with the most reliable internet service provider (ISP) and equipment, technical issues can arise, disrupting your sessions and potentially impacting the therapeutic relationship.

In this article, we'll explore strategies for minimizing the risk of internet interruptions and effectively handling them when they occur.

The Impact of Internet Interruptions on Telehealth

Internet interruptions during telehealth sessions can have a significant impact on the quality and effectiveness of the therapeutic process. Research has shown that technical issues, such as poor audio or video quality, can negatively affect the therapeutic alliance, client satisfaction, and treatment outcomes (Backhaus et al., 2012; Langarizadeh et al., 2017).

In a study by Guinart et al. (2021), clients reported feeling frustrated, disconnected, and less engaged when internet interruptions occurred during their telehealth sessions. The authors emphasize the importance of proactively addressing potential technical issues and having a plan in place to handle interruptions when they arise.

Choosing a Reliable Internet Service Provider

The first step in minimizing the risk of internet interruptions is selecting a reliable ISP that can provide fast, stable internet speeds suitable for telehealth services.

When evaluating ISPs, consider the following factors:

Speed: Look for an ISP that offers internet speeds of at least 25 Mbps (megabits per second) for download and 3 Mbps for upload. These speeds are generally sufficient for high-quality video conferencing (Federal Communications Commission, 2021).
Latency: Latency, or ping, refers to the time it takes for data to travel from your device to the ISP's server and back. Lower latency means a more responsive connection, which is crucial for real-time communication. Aim for an ISP with latency below 50 ms (milliseconds) (Speedtest, 2021).
Reliability: Research the ISP's uptime and customer satisfaction ratings to gauge their reliability. Look for an ISP with an uptime guarantee of at least 99% and positive reviews from other customers in your area (Federal Communications Commission, 2021).
Technology: Consider the type of internet connection technology offered by the ISP. Fiber-optic and cable connections generally provide faster and more reliable speeds compared to DSL or satellite (Federal Communications Commission, 2021).

Optimizing Your Home Network

In addition to selecting a reliable ISP, optimizing your home network can help reduce the risk of internet interruptions during telehealth sessions.

Wired connection: Whenever possible, use a wired Ethernet connection instead of Wi-Fi. Wired connections provide faster, more stable speeds and are less susceptible to interference from other devices or physical barriers (Speedtest, 2021).
Router placement: Position your router in a central location, away from walls and other obstacles that can weaken the signal. Keep the router away from other electronic devices that may cause interference, such as microwaves or cordless phones (Federal Communications Commission, 2021).
Bandwidth management: Prioritize your telehealth traffic by limiting bandwidth usage from other devices during sessions. Ask family members or roommates to avoid streaming videos, playing online games, or downloading large files during your scheduled sessions (American Psychological Association, 2020).
Quality of Service (QoS): If your router supports QoS settings, configure them to prioritize video conferencing traffic over other types of internet traffic. This can help ensure that your telehealth sessions receive the necessary bandwidth and reduce the risk of interruptions (Speedtest, 2021).

Preparing for Internet Interruptions

Despite your best efforts to optimize your internet connection, interruptions can still occur. To minimize the impact of these disruptions on your telehealth sessions, it's essential to have a plan in place.

Backup internet connection: Consider investing in a backup internet connection, such as a mobile hotspot or a secondary ISP, that you can switch to in case your primary connection fails (American Psychological Association, 2020).
Offline materials: Prepare offline materials, such as worksheets or handouts, that you can share with your clients in case of an internet outage. These materials can help maintain continuity and engagement even when you're unable to connect via video (Perle et al., 2014).
Communication plan: Establish a communication plan with your clients for handling internet interruptions. This may include providing them with a phone number where they can reach you, agreeing on a protocol for rescheduling sessions, or having a backup video conferencing platform (Perle et al., 2014).
Technical support resources: Familiarize yourself with the technical support resources provided by your ISP, router manufacturer, and telehealth platform. Keep their contact information readily available in case you need assistance troubleshooting issues (American Psychological Association, 2020).

Handling Internet Interruptions During Sessions

When an internet interruption occurs during a telehealth session, it's crucial to remain calm and communicate clearly with your client.

Acknowledge the issue: Promptly acknowledge the interruption and reassure your client that you're working to resolve it. This can help reduce their anxiety and maintain the therapeutic relationship (Perle et al., 2014).
Troubleshoot the issue: Attempt to identify and resolve the issue quickly. This may involve checking your internet connection, restarting your router, or switching to your backup connection (American Psychological Association, 2020).
Communicate with your client: Keep your client informed about your progress in resolving the issue. If the interruption persists, discuss alternative options, such as rescheduling the session or switching to a phone call (Perle et al., 2014).
Document the interruption: Record the date, time, and duration of the interruption, as well as any steps taken to resolve it, in your session notes. This documentation can be useful for tracking patterns, identifying areas for improvement, and maintaining accurate records (American Psychological Association, 2020).

Learning from Internet Interruptions

While internet interruptions can be frustrating, they also provide valuable opportunities for learning and growth.

Reflect on the experience: Take time to reflect on how you handled the interruption and what you might do differently in the future. Consider seeking feedback from your client on their experience and how you can better support them during technical issues (Perle et al., 2014).
Identify areas for improvement: Use your experience to identify areas where you can improve your technical setup, communication plan, or troubleshooting skills. Continuously update and refine your plan for handling internet interruptions based on your learnings (American Psychological Association, 2020).
Seek additional training: Consider pursuing additional training or continuing education opportunities related to telehealth technology and troubleshooting. Staying up-to-date with the latest best practices and tools can help you provide high-quality, uninterrupted care to your clients (Perle et al., 2014).

Conclusion

Internet interruptions are an inevitable part of providing telehealth services, but with proper planning and preparation, you can minimize their impact on your sessions and the therapeutic relationship. By selecting a reliable ISP, optimizing your home network, and having a plan in place for handling interruptions, you can ensure that you're able to provide consistent, high-quality care to your clients, even in the face of technical challenges.

Remember, the key to successfully navigating internet interruptions is clear communication, both with your clients and with technical support resources. By staying calm, focused, and solutions-oriented, you can model resilience and adaptability for your clients, strengthening the therapeutic alliance and promoting positive outcomes.

References:

American Psychological Association. (2020). How to make the most of telepsychology and steer clear of pitfalls. https://www.apa.org/monitor/2020/07/cover-telepsychology

Backhaus, A., Agha, Z., Maglione, M. L., Repp, A., Ross, B., Zuest, D., Rice-Thorp, N. M., Lohr, J., & Thorp, S. R. (2012). Videoconferencing psychotherapy: A systematic review.

Psychological Services, 9(2), 111-131. https://doi.org/10.1037/a0027924

Federal Communications Commission. (2021). Broadband speed guide. https://www.fcc.gov/consumers/guides/broadband-speed-guide

Guinart, D., Marcy, P., Hauser, M., Dwyer, M., & Kane, J. M. (2021). Mental health care providers' attitudes toward telepsychiatry: A systemwide, multisite survey during the COVID-19 pandemic. Psychiatric Services, 72(6), 704-707. https://doi.org/10.1176/appi.ps.202000441

Langarizadeh, M., Tabatabaei, M. S., Tavakol, K., Naghipour, M., Rostami, A., & Moghbeli, F. (2017). Telemental health care, an effective alternative to conventional mental care: A systematic review. Acta Informatica Medica, 25(4), 240-246. https://doi.org/10.5455/aim.2017.25.240-246

Perle, J. G., Burt, J., & Higgins, W. J. (2014). Psychologist and physician interest in telehealth training and referral for mental health services: An exploratory study. Journal of Technology in Human Services, 32(3), 158-185. https://doi.org/10.1080/15228835.2014.894488

Speedtest. (2021). How much internet speed do I need? https://www.speedtest.net/about/knowledge/how-much-internet-speed-do-i-need