TELEHEALTH CONSENT POLICY

At Rheumatologist OnCall, PC we are committed to providing you with top-quality telehealth services. These Terms of Use (“Terms”) outline the guidelines for using our telemedicine platform. Please carefully review these Terms before accessing our services. We may update these Terms or modify features of our platform, so please stay informed.

By using our services, you agree to these Terms and any subsequent changes we may make.

Your Privacy Matters.

We hold your privacy in the highest regard, and we strictly adhere to the Health Insurance Portability and Accountability Act (HIPAA) to protect your health information. Your information is never shared with third parties without your explicit consent, except for treatment, payment, or healthcare operations.

What You Should Know About Telemedicine

To better serve the needs of our community, health care services are now available by interactive video communications and the electronic exchange of information (e.g., patient medical records, medical images, live two-way audio and video, medical device output, etc.). This process is referred to as “telemedicine.”

Telemedicine involves the use of electronic communications to enable physicians and other healthcare providers at different locations to share patient medical information for the purpose of delivering convenient, efficient, and effective patient care. The telemedicine technology systems incorporate network and software security protocols to protect the confidentiality of patient information and imaging data. In addition, the telemedicine technology includes physical, technical, and administrative safeguards intended to secure and ensure the integrity of patient information.

Telemedicine is expected to improve access to medical care by enabling a patient to remain at a remote site while the provider obtains test results and consults from healthcare practitioners at distant sites. Telemedicine may also offer more efficient medical evaluation and management, particularly when obtaining the expertise of a distant specialist.

During telehealth sessions, your provider will use video-conferencing technology. With your consent, these sessions may be recorded for quality assurance, training, research, and safety purposes, and may include live two-way audio, video, and other materials.

Benefits of Telemedicine

• Convenient access to healthcare providers from the comfort of your home or office.
• Streamlined access to medical evaluation and management.
• Telemedicine consultations are different from in-person visits, as you and your provider won’t be in the same room.
• You have the right to ask questions about the benefits and risks of telehealth.
• Privacy and confidentiality protections apply to telemedicine.
• Results from telehealth services cannot be guaranteed.
• Your healthcare information may be shared for treatment, payment, and healthcare operations.

Risks of Telemedicine

While the use of telemedicine technology is intended to expedite the delivery of high-quality care in a convenient and effective manner, there are potential risks associated with telemedicine. These risks may include, but are not limited to, the following:

• Information transmitted may not be sufficient (e.g., poor resolution of images) to allow for appropriate medical decision making by the on-site or distant site provider;
• Technical deficiencies or failures may delay medical evaluation or treatment.
• Transmission or storage of patient’s medical information could be interrupted, accessed or intercepted by an unauthorized person;
• A lack of access to the patient’s complete medical record may result in adverse drug interactions, allergic reactions, or other judgment errors; or
• It may become apparent that the telemedicine technology cannot provide adequate clinical information during the procedure. If this occurs, the provider will inform the patient prior to the conclusion of the live telemedicine interaction and counsel the patient regarding the need for the patient to obtain an additional in-person medical evaluation with an appropriate provider.

Necessity of In-Person Evaluation

If it becomes clear that the telemedicine modality is unable to provide all pertinent clinical information during a particular telemedicine encounter, the treatment Provider will make it known to the patient prior to the conclusion of the live telemedicine encounter. The Treatment Provider will counsel the patient prior to the conclusion of the live telemedicine encounter regarding the need for the patient to obtain an additional in-person medical evaluation reasonably able to meet the patient’s needs.

Important Information

Rheumatologist OnCall, PC is not an insurance. Rheumatologist OnCall, PC is out of network with all commercial insurances.  We have opted out of Medicare. Out-of-network services are subject to your plan’s cost-sharing and billing rules. If preferred, you may use your insurance to cover the cost of your laboratory, imaging, and treatment expenses.

Access to Medical Records

You have the right to access your medical records and to request that they be shared with your Primary care physician, other specialists, and healthcare providers. You should use our patient portal to request the medical records or send us an email to  [email protected].

Circumstances for Sharing Healthcare Information

• Valid court orders for medical records.
• Reporting suspected abuse, neglect, or domestic violence.
• Preventing or reducing a serious threat to anyone’s health or safety.

The Telehealth Consent Form will be also sent to you to sign when you enroll to become a new patient at Rheumatologist OnCall, PC.

By signing this form, you understand the following:

• You have the right to withhold or withdraw your consent to the use of telemedicine during your medical care at any time without affecting your right to future care or treatment.
• The laws that protect privacy and the confidentiality of medical information also apply to telemedicine. The information disclosed by you during the course of your treatment is generally confidential, but there are mandatory and permissive exceptions to confidentiality.
• The dissemination of any personally identifiable images or information from the telemedicine interaction to researchers or other entities shall not occur without your consent.
• You have the right to inspect all information obtained and recorded during a telemedicine interaction and may obtain copies of such information for a reasonable fee.
• Telemedicine is one of a variety of modalities that may be available to you for the provision of medical care.
• You may refuse to participate in a telemedicine interaction and ask your provider about alternative methods of care.
• Telemedicine may involve your provider’s electronic transmission of your personal health information to distant-site providers.
• It is your duty to inform your provider of other electronic interactions or telemedicine interactions involving your health that you may have with other healthcare providers.
• If your provider believes you would be better served by another form of service (e.g. face-to- face), you will be referred to another provider in your area who can provide the necessary care.

• In the event of an adverse reaction to treatment or an inability to communicate due to a technological or equipment failure, you agree that you will seek follow-up care or assistance at your provider’s recommendation.
• You understand that no warranty or guarantee has been made to you with regard to any result or cure.
• You have been given an opportunity to ask questions about your condition, alternative forms of treatment, risks of non-treatment, the procedures to be used, and the risks and hazards involved, and you believe that you have sufficient information to give this informed consent.
• You certify this form has been fully explained to you that you have read it or have had it read to you, and that you understand its contents.
• You have read and understand the information provided above regarding telemedicine. You understand that you have the opportunity to discuss the telemedicine, including, without limitation, the risks and benefits involved, with your provider or such associates, consultants or other allied health professionals as may be designated. You hereby give your informed consent for the use of telemedicine in your medical care.
• You hereby authorize our provider and its employees, agents and independent contractors, to use telemedicine in the course of your diagnosis and treatment.

For those Who Receive Services in the State of Texas

Complaints with the Texas Medical Board against Treatment Providers, as well as other licensees and registrants of the Texas Medical Board, may be reported for investigation at the following address:

Texas Medical Board Attention

Investigations 333 Guadalupe,

Tower 3, Suite 610

P.O. Box 2018, MC-263

Austin, Texas 78768-2018

Assistance with filing a complaint is available by calling the following

telephone number: 1- 800-201-9353.

For more information, please visit the Texas Medical Board website at www.tmb.state.tx.us.

Electronic Communications Consent

You understand that electronic communication (e-mail and SMS) is convenient and not appropriate for emergencies or time-sensitive issues. Additionally, you understand that the security and privacy of electronic communications cannot be guaranteed. Further, you understand that electronic communications should not be used to transmit highly sensitive or personal information. You consent to e-mail and SMS communication with Rheumatologist OnCall EMR /telemedicine system.

Patient Consent to the Use of Telemedicine

By accepting these Terms, you acknowledge that you have read and understood the information provided.

You comprehend the risks and benefits of our services and hereby consent to telehealth as a valid means of receiving healthcare services during your sessions with Rheumatologist OnCall, PC.