Telehealth Informed Consent

1. What is Telehealth?

Telehealth involves the use of electronic communications to enable healthcare providers at different locations to share individual patient medical information for the purpose of improving patient care. The information may be used for diagnosis, therapy, follow-up, and/or education, and may include patient medical records, medical images, live two-way audio and video, interactive audio, and output data from medical devices and sound and video files.

2. Expected Benefits

Potential benefits of telehealth include: improved access to medical care by enabling a patient to remain at home or at a remote site while consulting with a provider; more efficient medical evaluation and management; obtaining expertise of a distant specialist; and reduced travel time and associated stresses.

3. Possible Risks

As with any medical procedure, there are potential risks associated with the use of telehealth. These risks include, but may not be limited to: in rare cases, information transmitted may not be sufficient to allow for appropriate medical decision making; delays in medical evaluation and treatment could occur due to deficiencies or failures of the equipment; in very rare instances, security protocols could fail, causing a breach of privacy of personal medical information.

4. Your Rights

You have the right to: withhold or withdraw consent to the use of telehealth in the course of your care at any time, without affecting your right to future care or treatment; inspect all information obtained and recorded in the course of a telehealth interaction; receive a copy of all documentation from your telehealth consultation; and have all existing confidentiality protections apply to information disclosed during a telehealth consultation.

5. Physician Independence

The physician reviewing your intake is an independent licensed practitioner. They exercise independent medical judgment and may decline to issue a prescription if they determine it is not clinically appropriate for you. Empire Health does not direct or influence physician prescribing decisions.

6. Emergency Situations

Telehealth is not appropriate for emergency medical situations. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Do not use the Empire Health platform for emergency care.

7. Consent

By proceeding with your intake and submitting your health information through the Empire Health platform, you acknowledge that you have read and understood this Telehealth Informed Consent, that you have had the opportunity to ask questions, and that you voluntarily consent to receive telehealth services through Empire Health.