Telemedicine Consent


Not all insurances cover this service. Not every telemedicine service will be appropriate for a video call , this is only for patients who can not come into the office. Some patients might be better served coming into the office for their care due to availability of lab testing or hand-on examination. Telemedicine services are subject to approval by the treating physician.

 Telemedicine involves the use of electronic communications to enable health care providers at different locations to share individual patient medical information for the purpose of improving patient care.  Providers may include primary care practitioners, specialist, and/or subspecialists. The information may be used for diagnosis, therapy, follow-up and/or education, and may include any of the following:

  • Patient medical records
  • Medical images
  • Live two-way audio and video
  • Output data from medical devices and sound and video files

Electronic system use 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.

Expected Benefits

 Improved access to medical care by enabling a patient to remain in his/her physician’s office (or at a remote site) while the physician obtains test results and consults from healthcare practitioners at distant/other sites.

  • More efficient medical evaluation and management
  • Obtaining expertise of a distant specialist

 Possible Risk

As with any medical procedure, there are potential risk associated with the use of telemedicine. 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 physician and consultants(s);
  • Delays in medical evaluation and treatment could occur due to deficiencies or failure of the equipment;
  • In very rare instances, security protocols could fail, causing a breach of privacy of personal medical information;
  • In rare cases, a lack of access to complete medical records may result in adverse drug interactions or allergic reactions or other judgment errors

By requesting Telemedicine services you indicate your understanding of the possible risks and benefits.

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