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publishers of The New England Journal of Medicine
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Guidelines for Online Communications With Your Patients

The intersection of health care delivery and the Internet poses significant benefits to patient care, but also brings with it inherent legal risks for physicians who choose to incorporate online communications into their medical practice. A working group of physician organizations, that is led by Medem, Inc. (which offers physician practice website services to MMS members and others) and which includes the MMS, state medicine boards and insurers, has crafted some very basic guidelines to assist physicians in evaluating and addressing potential legal concerns.

These e-Risk Guidelines address security, confidentiality, informed consent and licensing. The e-Risk Guidelines, for example, note that informed consent should be obtained from the patient prior to the initiation of online communications regarding the appropriate use and limitations of this form of communication. The guidelines further point out that online interactions with patients are subject to the requirements of state licensure.

This working group of health care organizations has also created guidelines specific to fee-based online consultation arrangements, addressing appropriate charges and fee disclosures, the physician-patient relationships and medical record keeping. e-Risk Guidelines and Fee-Based Online Consultation Guidelines

These guidelines are not intended to cover all of the potential legal liabilities and risks associated with the use of online communications in your practice. Physicians should consult their own legal counsel to appropriately evaluate issues specific to their individual practices.

- Saliha Khaja, Esq.

The "Law and Ethics" column is provided for educational purposes and should not be construed as legal advice. Readers with specific legal questions should consult with a private attorney.

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