Section 6: Telehealth

What is Telehealth and Telemedicine?

  1. Telehealth are Healthcare services delivered via asynchronous (store and forward), remote patient monitoring, teledentistry, or telemedicine (interactive audio and video) (AHCCCS Medical Policy Manual, Section 320-I Tele-Health).
  2. Tele-Medicine is the practice of synchronous (real-time) health care delivery, diagnosis, consultation and treatment and the transfer of medical data through interactive audio and video communications that occur in the physical presence of the Member. (AHCCCS Medical Policy Manual, Section 320-I Tele-Health).
  3. For all practical purposes, telehealth and telemedicine will be referred to as โ€œtelehealthโ€.

Confidentiality

  1. I understand that the laws that protect privacy and the confidentiality of medical information also apply to telehealth, and that no information obtained in the use of telehealth which identifies me will be disclosed to researchers or other entities without my consent.
  2. I understand that telehealth may involve electronic communication of my personal medical information to other medical practitioners who may be located in other areas, including out of state.
  3. I understand that it is my duty to inform my provider of electronic interactions regarding my care that I may have with other healthcare providers. I am aware that the telehealth visit consists of using a secure teleconferencing system to engage face to face via teleconference technology which could include: a webcam, microphone, laptop, smart phone and/or desktop computer.
  4. I am aware that I may be asked for proof of identification to authenticate my identify.
  5. Touchstone Health Services (THS) utilizes technological platforms, including those for the purposes of video and audioconferencing technology, that meet the requirements outlined by the Health Insurance Portability and Accountability Act (HIPAA). Platforms used for telemedicine/telehealth include, but not limited to, Zoom. I understand that the use of telecommunication audio/video systems are not 100% secure and may have issues with connectivity. All attempts to keep information confidential while using these systems will be made, but a guarantee of 100% confidentiality cannot be made.
  6. During telemedicine/telehealth sessions, no persons, other than those agreed to by the parent/guardian will observe, monitor or hear the contents of the session. THS staff will disclose, at the onset of session, if there are any other participants at the location of the remote session. To ensure this confidentiality, the staff will remain behind closed doors, use headphones and post a sign on the door stating clinical session is in progress, if applicable. Additional safeguards will be implemented should the clinician see applicable to ensure confidentiality.
  7. I agree to the use of a video recording if clinically necessary to improve health outcomes.

Benefits/Risks

  1. I am aware that utilizing telehealth may provide improved access to care and offers the opportunity to receive services in the comfort of my home or preferred environment.
  2. I understand that the efficacy of telehealth can be affected by problems with internet connection, data usage and other technological barriers.
  3. I understand that I may expect the anticipated benefits from the use of telehealth in my care, but that no results can be guaranteed or assured.

Emergency Procedures

  1. In times of emergency, as defined by federal and local authorities, I understand that alternative technological options may be utilized to help me that may not be HIPAA compliant. (Ex. Facetime, Video Calling etc.)
  2. In the event you cannot get ahold of a THS staff member and there is a medical or life-threatening emergency, please contact 911. If you or the Member are in crisis and in Maricopa County, please call the Crisis line at 602.222.9444. If you are in Pima or Pinal County, please call the crisis line at 1-866-495-6735.

Additional Considerations

  1. I understand that I have the right to withhold or withdraw my consent to the use of telehealth in the course of my care at any time, without affecting my right to future care or treatment.
  2. I am aware that I (my child) has the right to have a support person present to accompany me (my child) during a telehealth appointment upon request.
  3. I am aware that to ensure I can communicate and understand what is discussed using telehealth services, translation services through a licensed third party are available to me (my child) upon request.
  4. I understand that I have the right to inspect all information obtained and recorded in the course of a telehealth interaction and may receive copies of this information for a reasonable fee.
  5. I understand that a variety of alternative methods of medical care may be available to me, and that I may choose one or more of these at any time. My provider has explained the alternatives to my satisfaction.