What is Informed Consent?
If you’ve ever had an issue with your health, you may have found yourself overwhelmed and terrified by what will happen and what to do. Most people unlicensed as medical doctors do not have an operating knowledge of what certain conditions mean for their health. Nor do they understand what benefits and risks specific treatments and procedures may present.
Informed consent is valuable in making sure you are educated about your medical choices and options. Minor procedures may require a simple discussion; however, more complicated/invasive procedures or medical studies may require more in-depth explanation.
To guide you in well-considered decisions about your care, you have the right to get information and ask questions of your doctor. A patient-physician relationship with informed consent gives you insight to choose the best course of action for you. As a patient, you need to be able to trust your doctors to provide competent intervention and care, handle sensitive information securely, and prioritize your well being.
In-person patients often receive stacks of paperwork to fill out before being seen, as well as periodically throughout decision making and treatment. For example, in a doctor’s office you may sign a form or give a verbal acknowledgment stating you have been presented information and agree to a procedure. The benefit is two-fold, ensuring patient awareness and giving the doctor legal protection too.
Informed Consent in Telemedicine
In its convenience and cost savings, telemedicine uses technology and processes to make these discussions about healthcare more accessible. It is a useful tool that enhances diagnosis and treatment services. Getting patients’ informed consent is an important part of any telemedical service.
That being said, there are some unique considerations to ensure that you are fully aware of the services offered and provided by your telemedicine provider. As a new method reshaping how healthcare is delivered, it’s important to know how telemedicine works, what is included, and what limitations there may be.
Treating patients off-site can come with its own risks. Without an in-person, hands-on examination, physicians may be limited in their health evaluation. During a telemedical consultation, a patient receiving remote assistance may be concerned about privacy and wonder if any third-party person is present out of the camera’s view or in the vicinity of a phone consultation. In addition, while devices such as computers, cell phones, tablets, webcams and electronic health records can improve patient experience, there may be occasional technical difficulties, lost connections, or transmission hiccups. Issues in receiving data such as patient records or medical device printouts may postpone care or potentially lead to misdiagnosis.
Before you use a telehealth service, you may have many questions or expectations that need to be defined. What are the policies for scheduling, cancelling, and billing? What sort of equipment do you need to consult virtually with the doctor? How is your confidentiality is protected?
What Protects My Informed Consent?
To ensure that patients understand the medium through which they are receiving care, many states have introduced telemedicine-specific laws for informed consent. According to the Center for Connected Health Policy, Medicare doesn’t require informed consent be obtained from a patient before a telehealth-delivered service takes place. However, a majority of states either require informed consent be obtained within their Medicaid program or in their regulations of healthcare professionals. The American Telemedicine Association encourages telemedicine service providers to prioritize patient safety, transparency of operations and adherence to all relevant laws and regulations.
As with many telemedicine regulations, legal requirements for informed consent vary state by state and across fields of healthcare. Some states just require the standard patient consent; others have laws with telemedicine language. In addition, some have separate informed consent for telemedicine on top of the standard consent. To reference your state’s regulations, you can visit the Center for Connected Health Policy (CCHP) and the American Telemedicine Association (ATA).
Sometimes laws can be interpreted to mean informed consent must be received each time a patient uses telehealth. Other laws require informed consent only for the first telehealth visit when it is in a series of visits for the same condition.
What Informed Consent Should Look Like
Proper informed consent helps ensure that telehealth/telemedicine is appropriate for your situation and needs.
The American Medical Association recommends that telemedicine providers:
Educate users on how telemedicine technologies will be used in care and the credentials of health care professionals involved.
Inform users of their own responsibilities and expectations, as well as limitations of the services provided.
Encourage users to tell their primary physicians about their online health consultation and coordinate care
Advise users to arrange care in cases when there is a need for follow-up
Ensure health information and content for websites or mobile health applications be physician-reviewed as objective and accurate
Disclose any financial or other interests the physician has in the telehealth/telemedicine application or service and manage or eliminate conflicts of interests
Prevent unauthorized access and protect the security and integrity of patient information and confidentiality among health care professionals and other personnel who participate
Other helpful considerations include:
The nature and timing of the service
Recordkeeping methods of the provider
An explicit plan or alternative if care is interrupted or an issue occurs
Mandatory reporting requirements
Explanation on how you will be billed
Consent before recordings
Protocols for contact between visits
Sample informed consent forms can be accessed by contacting your local Telehealth Resource Center.
With a clear understanding of the care you will receive, you are equipped to be an active decision maker and take control of your health. Transparency helps you! Not only that, it also helps your telemedicine service provider serve you better and stay in legal and ethical compliance.
Responsible Telemedicine is an advocate for patients’ wellbeing and fair, quality treatment. Feel you’ve been treated unfairly? Contact us to talk about your experience.