How can telehealth affect IPV screening and safety, and what precautions should be taken?

• A. It can compromise privacy if the abuser is present; use private time, verify location, use safe words, ensure secure devices and confidential channels, have a safety plan for in-person follow-up.
• B. Telehealth always guarantees privacy.
• C. Telehealth is not relevant to IPV screening.
• D. Telehealth should replace all in-person visits.

Answer: (A)

Telehealth changes screening for IPV by bringing privacy and safety into remote encounters. The risk is real that the abuser could be present off-camera or monitor communications, which can silence disclosure or put the patient at risk. The best approach is to build in safeguards that protect confidentiality and give the patient control over when and how they speak.

Set up a private time for the session and verify the patient’s location at the start and as needed. Establish a safe word or signal the patient can use to pause or end the session if someone enters the room or if safety is compromised. Use secure devices and confidential channels—encrypted platforms, private patient portals, and prompts that minimize data exposure. Have a safety plan for in-person follow-up if risk is identified, including clear steps for connecting with local resources and ensuring the patient can access help safely.

These precautions acknowledge real-world risks and provide concrete steps to maintain safety while enabling IPV screening via telehealth. Telehealth can be a valuable tool, but privacy is not guaranteed in all situations, and it should complement—not replace—in-person care when needed.