Telemedicine has become an integral part of practice during this pandemic. But the question arises: How should you get patient consent and is it even necessary?

Posted in Coronavirus on Wednesday, June 24, 2020

The COVID-19 pandemic has accelerated the use of telemedicine, many times with practitioners who had not used or even considered it previously. As telehealth becomes more widely incorporated into practices, we’ve been receiving questions about whether a consent form is necessary and how to orchestrate getting that form signed or acknowledged. 

Consider Using a Form 

Some states require a form when telemedicine is being used, while other states have waived the required use of the form during the pandemic. (That does not mean the waiver will continue after recovery.) It’s also essential that you know the state regulations of the state where your patient is located. Even if the state you and/or your patient are in does not require the use of a form, we still recommend using one as it provides a convenient checklist to make sure all the issues (risks and benefits) are addressed. Using a form also makes it easy to document that the consent discussion was completed as the form can be scanned into the records.  

How to Get Forms Signed

As you prepare for the telemedicine visit, the form can easily be mailed to the patient ahead of time, or put on your patient portal. If you are mailing the form, send two copies so the patient can keep one copy and return a signed copy to you. Provide a stamped return envelope to make it easy for them. If they are using your portal, you may need to explain how to electronically sign the form.

Another possibility to consider is scanning the form, then emailing it to your patient to e-sign through a secure documentation system. Make sure you are using a HIPAA-compliant system if you go this route. You’ll also need to obtain the patient’s consent to email them the form. As you are probably aware, there are 18 identifiers associated with protected healthcare information. So, it would be important to not include any two identifiers which could identify the patient: 

• For example, remove the date of birth (as you know practices use your date of birth as an identifier). It would have to be verbally confirmed when the actual telemedicine visit is made
• Make the Patient Record Number to “office use only” or not include it at all
• Make location to “office use only”

Consider Interpretation Needs

When you are ready to have the consent discussion, be sure to consider whether your patient will need an interpreter. If an interpreter is involved, document the name of the interpreter and their organization. If the interpreter is a member of your staff, note their role in your organization. Be sure to review the entire form with the patient. 

Make Information Easy to Understand

Your goal is to make sure the patient understands the risks, benefits and alternatives to telemedicine and the cost. Use easy-to-understand information and confirm their understanding during the discussion. Finally, ask the patient to sign the form and either return a copy to you or go to your portal to sign the form there. 

If the patient has verbally agreed to the virtual visit, you can continue to have the visit. Be sure to document in your records that the patient advises they will return the signed form or sign the form on the portal.