Telemedicine Consent

Telemedicine allows treatment providers to evaluate, diagnose, and treat patients at a distance using telecommunications technology without an in-person visit. Treatment is provided via a real-time, two-way, secure video and audio connection between the treatment provider and patient. Telemedicine is frequently used for follow-up visits, management of chronic conditions (including addiction and behavioral health), medication discussions & refills, and a host of other clinical services.

1. The right to stop or refuse treatment. Inform any staff member at Kemet and we will find an alternative for you.
2. The right for telemedicine to be treated the same as an in-person visit.
3. You have the right to receive safe and quality care within the range of services that telemedicine provides.
4. You have the right to be told the names of all health care team members providing your telemedicine care.
5. You have the right to have a family member, support person, or other individual be present with you for emotional support, unless the individual’s presence infringes on your safety, or is medically or therapeutically contraindicated.
6. You have the right to request an in-person consultation should you feel that the telemedicine consultation is less than adequate or otherwise unsatisfactory.
7. You have the right to ask any support personnel assisting in your telemedicine consultation to leave the room or discontinue viewing/listening to your consultation at your request.

1. You are responsible for selecting a secure private location when accessing telemedicine. This is not always easy, but you need to provide proper safeguards to your own privacy. We discourage accessing telemedicine when in public.
2. You have the right to file a complaint or grievance for issues relating to telemedicine. This is standard across all of our services. Please inform a Kemet staff member if you wish to pursue this.
3. Call Kemet if technology or equipment fails during a telemedicine session. Technology is not perfect and we may become disconnected. We will hold you harmless for any information lost on a session.
4. Inform Kemet of any schedule changes or cancellation. Please let us know if you cannot make a session. Unlike our normal hours of operation, we will charge you if you request a custom time for telemedicine and do not attend – depending on the impact on our provider team.

1. Potential Benefit: Improved Access to Treatment. You will be able to receive treatment when traveling or if you have transportation issues.
2. Potential Benefit: Scheduling Flexibility. Telemedicine gives you more options to access treatment with Kemet by picking a time that works for both you and one of our providers. This may be outside our normal hours of operation.
3. Constraint: Quality of Care. You may not experience the same quality of treatment services that you enjoy in person.
4. Constraints: Access to Proper Technology. To access telemedicine at home you must have a device that can access the internet. You may find that the internet is not working, or your device does not have the proper capabilities. We do not have the ability to provide you with a device to access telemedicine from home; you will need to do so yourself.
5. Risk: Privacy & Security. We strongly encourage you to find a private place when accessing telemedicine outside of our clinic. We manage the risk of privacy and security on our end by using this technology in a private & secure manner. We use encrypted teleconferencing software and password protect our computers, never leaving them unattended.
6. Risk: Possible Breaches. The telemedicine technology we use may be hacked or otherwise become compromised. We selected Doxy.me for their quality reviews and track record but may select a different technology provider in the future.
7. Alternatives: The only main alternative to telemedicine is to access treatment in our clinic, or to request referral to another treatment provider. We will do our best to accommodate your needs