Massachusetts Medical Society: What you Need to Know about Telemedicine and Informed Consent

What you Need to Know about Telemedicine and Informed Consent

Illustration by Chris Twichell

The COVID-19 pandemic greatly accelerated the adoption of telehealth for patient visits. Most physicians understand they must obtain informed consent from their patient (or patient’s representative) before any medical procedure or intervention, but many do not know that it is important to obtain informed consent for a telehealth visit as well.

As part of the Committee on Professional Liability’s responsibility to monitor the professional liability market in Massachusetts and educate members about developments in professional liability, the committee is sharing these basic steps and reminders.

If your office does not yet have an informed-consent form for telehealth, the federal Agency for Healthcare Research and Quality provides an easy-to-understand telehealth consent form, which physicians can adapt for their own use.

In order to obtain informed consent for a virtual visit, the physician should explain to the patient and document that the following explanations have been provided:

  • What telehealth is.
  • Advantages of telehealth.
  • Potential harms and risks of telehealth.
  • The limits of telehealth visits.
  • The privacy of telehealth.
  • The option of an in-person office visit.
  • The patient’s ability to change their mind at any time during the visit, and withdraw consent, without penalty, for the telehealth visit.

Furthermore, a physician or other provider or staff member should inform the patient of:

  • How, where, and when the telehealth visit will take place.
  • The nature of the technology and how it can be used.
  • The potential for an equipment or technology failure that could result in an incomplete or inaccurate diagnosis.
  • How to receive follow-up care, both virtually or in-person, in the event of a technological breakdown, unforeseen outcome, or an emergency.

The limitations of virtual visits (for example, a physician cannot palpate a mass via telehealth) should be made clear to the patient. If, during the patient’s visit, one of those limitations arises, that fact should be clearly communicated to the patient. The physician should then ask the patient to come into the office for an in-person visit. If the patient refuses, the physician should document the recommendation and the refusal against medical advice in the patient’s record.

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