In order to improve access to health care, Hanley Foundation (“Hanley”) has implemented telehealth virtual visits via audio-visual, real-time, two-way interactive communication systems for its patients.
Introduction to Telehealth
Telehealth is the delivery of healthcare services through the use of technology when the healthcare provider and patient are not in the same physical location. Providers may include primary care providers, specialists, and/or sub specialists. Electronically-transmitted information may be used for diagnosis, therapy, follow-up and/or patient education, and may include patient medical records, interactive audio, video, and/or data communications. Telehealth services may involve electronic communication of personal health information to providers who may be located in other areas, including out-of-state.
The interactive electronic systems used will incorporate network and software security protocols to protect the confidentiality of patient identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.
Potential Benefits
Improved access to healthcare by enabling a patient to remain at remote site while the provider offers services another location. Convenient evaluation and management. Obtaining the expertise of a distant specialist.
Potential Risks
As with any healthcare service, there are potential risks associated with the use of telehealth. These risks include, but may not be limited to: Information transmitted may not be sufficient (e.g., poor resolution of images) to allow for appropriate healthcare decision making by the provider and/or consultant(s). The consulting provider(s) are not able to provide treatment to the patient through the use of telehealth equipment nor provide for or arrange for any emergency care that may be required. Delays in evaluation and treatment could occur due to deficiencies or failures of the equipment. Security protocols could fail, causing a breach of privacy of personal health and/or identifying information.
Confidentiality
Privacy laws for confidentiality of my protected health information apply to telehealth services unless an exception applies or disclosure is required by law. Hanley’s Notice of Privacy Practices is provided to all patients in the patient handbook (“Handbook”), a copy of which has been provided, and contains very important information about the privacy and confidentiality of your health information, your privacy rights, and how you can exercise these rights. Confidentiality is required in therapeutic groups. Anything said between any two or more group members at any time is part of the group and is confidential. All patients participating in therapeutic groups agree and sign understanding that they agree to keep information shared in group by other participants confidential. All patients participating in therapeutic group sessions via telehealth will have signed this form.
Telehealth services sessions will not be recorded by Origins and may not be recorded by other participants. All information disclosed within sessions and written records pertaining to those sessions are confidential and may not be disclosed to anyone without written authorization, except where the disclosure is permitted and/or required by law.
Session Expectations
There will be certain expectations and requirements of patients participating in a telehealth session. At the beginning of each session, Hanley will confirm each participant’s equipment and specific location, and ensure confidentiality can be maintained throughout the duration of the session. In addition, Origins will outline such other rules and procedures expected of the participants. If breaks are permitted, participants must ensure their equipment is muted and properly secured to prevent unauthorized access when taking a break.
By signing this form, I understand and agree to the following:
I consent to receive healthcare services via telehealth technologies from Hanley and its staff. I have the right to withhold or withdraw my consent to the use of telehealth during the course of my care at any time.
I understand that my withdrawal of consent will not affect any future care or treatment, nor will it subject me to the risk of loss or withdrawal of any health benefits to which I am otherwise entitled.
In lieu of telehealth services, I may seek services at a different time with Hanley. A variety of alternative methods of care may be available to me, and I may choose one or more of these at any time. Hanley has explained the alternative care methods to my satisfaction.
I may expect the anticipated benefits from the use of telehealth in my care, but that no results can be guaranteed or assured. My condition may not be cured or improved, and in some cases, may get worse.
I further understand that in the event my provider determines telehealth services are not in my best interest, my provider will inform me of that determination and discuss alternative options better suited to my care and needs, including the resumption of in-person visits as indicated or required.
Any questions I may have regarding the telehealth services or my overall treatment may be directed to Hanley during my telehealth services sessions.
I will not record or permit the recording of any telehealth session without the prior written consent of Hanley.
The laws that protect the privacy and confidentiality of health and identifying information also apply to telehealth.
Everything said in a group session is confidential and I will keep confidential the names of other members of the group session and what is said during the group session.
All other Hanley rules and regulations are in full force and effect regardless of whether services are delivered to me via telehealth communication or in person.
In order to facilitate Origins’ delivery of telehealth services, I must take steps to minimize the presence and effects of Interruptions, including ensuring:
(1) my device is connected to a wireless local area network (commonly known as Wi-Fi) or another internet source with sufficient speed to stream audio and video without interruption or delay;
(2) my device is not used for texting, chatting, phone calls, or video calls other than the telehealth services during a session; and
(3) other devices connected to my internet source are turned off or disconnected from the internet, so as not to become an Interruption to the telehealth services.
I will adhere to Origins’ expectations and requirements for participation in telehealth session. I will be honest in confirming my equipment and specific location, and will remain at the location throughout the duration of the session. At the location at which I engage in the telehealth services, it is my responsibility to create an environment that is not subject to unexpected or unauthorized intrusion and I must place myself in a private area to ensure privacy and confidentiality. If I take a break, I will take necessary steps to prevent disruption to the session and unauthorized access by others. I will limit telehealth services attendees to just me unless otherwise approved in advanced by Origins. I understand that telehealth services do not provide and are not a substitute for emergency care services, and I agree to seek emergency care services if the need arises.