Informed Consent for Services Performed by Dr. Vineet Nakra
Teleconferencing opinions involve the use of electronic communications to enable oncology experts at different locations to share individual patient health information for the purpose of improving patient care. Providers may include multiple forms of specialists, and/or subspecialists. The information may be used for providing relevant information to you, and may include any of the following:
- Customer health records
- Medical images
- Online counseling and support groups
- Output data from medical devices and any files
Electronic systems used 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.
Responsibility for the patient care should remain with the patient’s local clinician, if you have one, as does the patient’s medical record.
Expected Benefits:
- Improved and rapid access to a team of oncology experts by enabling a person to remain in his/her local healthcare site (i.e. home) while the expert provides information to patients.
- Clear evaluation of therapeutic options.
- Confidence in understanding options and implications of those options.
Possible Risks:
As with any medical procedure, there are potential risks associated with the use of online second opinion. These risks include, but may not be limited to:
- In rare cases, the team may determine that the transmitted information is of inadequate quality, thus necessitating a face-to-face meeting with the customer, or at least a rescheduled video session;
- Delays in services could occur due to deficiencies or failures of the logistics;
- In very rare instances, security protocols could fail, causing a breach of privacy of personal health information;
- In rare cases, a lack of access to complete records may result in judgment errors;
By approaching the doctor through this website, you acknowledge that you understand and agree with the following:
- I understand that the laws that protect privacy and the confidentiality of medical information also apply to second opinion services, and that no information obtained in the use of services, which identifies me, will be disclosed to researchers or other entities without my written consent.
- I understand that I have the right to withhold or withdraw my consent to the use of services at any time, without affecting my right to future services.
- I understand that online expert opinions may involve electronic communication of my personal health information to other medical practitioners who may be located in other areas, including out of state.
- I understand that I may expect the anticipated benefits from the use of online expert opinion, but that no results can be guaranteed or assured.
- I understand that my healthcare information may be shared with other individuals for scheduling and billing purposes.
Customer Consent To The Use of Online Communication for Expert Opinion
I have read and understand the information provided above regarding online expert opinions, have discussed it with my physician or such assistants as may be designated, and all of my questions have been answered to my satisfaction.
I have read this document carefully, and understand the risks and benefits of the services given and have had my questions explained and I hereby give my informed consent to participate in online expert opinion under the terms described herein.
By agreeing to proceed with my online expert opinion, I hereby state that I have read, understood, and agree to the terms of this document.
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