PHOENIX PREFERRED CARE, INC.
INFORMED CONSENT for TELEHEALTH SERVICES
INTRODUCTION
Telehealth involves the use of electronic communications to enable behavioral health care providers at different locations to share individual client medical information for the purpose of improving behavioral health client care. Certain individuals might have authorized or unauthorized access to such records or transmissions (e.g., colleagues, supervisors, employees, administrative assistants, billing personnel, information technology specialists, etc.). The information may be used for diagnosis, therapy, follow-up and/or education, and may include any of the following:
· Client medical records
· Behavioral health images
· Live two-way audio and video
· Output data from medical devices and sound and video files
Electronic systems used will incorporate network and software security protocols to protect the confidentiality of client identification. Imaging data will include measures to safeguard the data and to ensure its integrity against intentional and unintentional corruption.
EXPECTED BENEFITS
· Improve access to behavioral health care by enabling you to maintain access to your behavioral health provider from a remote site.
· More availability for the members of your treatment team to become part of your behavioral health treatment through the virtual meeting room.
· Obtaining expertise of a behavioral health professional without being required to drive to the office.
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 (e.g. poor resolution of images) to allow for appropriate medical decision making by the behavioral health professional and/or case manager.
· Delays in behavioral health evaluations and treatment could occur due to deficiencies or failures in equipment.
· In very rare instances, security protocols could fail, causing a breach of privacy of personal medical information.
· In the event an appointment is compromised due to technology failure, you will be contacted via telephone to reschedule.