CONSENT TO USE EMAIL, WEBFORMS, SMS/TEXT MESSAGING AND THIRD PARTY COMMUNICATION APPS

I. RISKS OF USING WEB-BASED COMMUNICATION (E-MAIL, WEB FORMS, TEXT AND SMS MESSAGING, AND THIRD PARTY COMMUNICATION APPS)


Cerbo Clinic, through their electronic medical record (EMR) vendor, Practice Fusion, offers patients and their legal guardians the opportunity to communicate directly using e-mail or text messaging. Secure patient access is provided through Practice Fusion’s patient portal “PatientFusion”.

Cerbo Clinic also uses secure web based communications including webforms and Third Party encrypted messaging apps (e.g. WhatsApp).

Each of these communication tools can facilitate better communication and there is great utility in improving communication between doctors and patients, to facilitate delivery of patient care.

However, using these web based electronic communication tools is different than traditional phone messaging. We encourage you to read up on the issues around electronic web based communication and the risks and caveats described below. Please take the time to understand your options and risks before using web based tools for communication with Cerbo Clinic.

Cerbo Clinic offers web based tools to facilitate appointment scheduling and payments. These tools are not intended to be used to convey medical information or to discuss medical conditions. You should only discuss details of your medical care with your physician, either on the phone or in person.

E-mail, text messaging, web page forms and third party communication apps have a number of possible risks that patients and their legal guardians should be aware of, prior to communicating with Cerbo Clinic through any of these tools.

If the patient or legal guardian is worried about any information being seen by other people, or if the question or problem is urgent, then other form(s) of communication such as telephone communication should be used.

Some of the possible risks of using web-based communications, such as e-mail, web forms, text messaging or third party apps include, but are not limited to, the following:

a. E-mail information or text messages can be sent on to other people, stored on a computer, or printed out on paper for storage.

b. E-mail or text messages can be sent out and received by many recipients, some or all of whom may be sent the e-mail accidently.

c. E-mail or text message senders can easily misaddress their message.

d. E-mail or text message information is easier to change than handwritten or signed documents.

e. E-mail or text message information may be kept on computers/electronic devices even after the sender or the recipient believes they deleted his or her copy.

f. Employers and on-line services have a right to archive (store) and look at e-mails and text messages transmitted through their systems. Some, but not all, employers store e-mail and text messages indefinitely.

g. E-mails, text messages, web form entries and Third Party app entries can occasionally be intercepted, changed, forwarded, or used without authorization or detection.

h. E-mails, text messages, and web forms can be used to introduce viruses into computer systems.

i. E-mail or text messages can be used as evidence in court.

j. Information sent through web forms or third party messaging apps may be intercepted and stored by third party vendors who may or may not subscribe to the legal mandates for Private Health Information (PHI) protections, such as those granted through State and Federal law (e.g. Health Insurance Portability and Accountability Act of 1996 (HIPAA).

II. CONDITIONS FOR THE USE OF E-MAIL, WEB FORMS, TEXT MESSAGING AND THIRD PARTY COMMUNICATION APPS

The health care providers will use reasonable means to protect the security and confidentiality of any and all information sent and received.

However, because of the risks outlined above, the health care providers cannot guarantee the security and confidentiality (privacy) of e-mails, text messaging communications, and of information exchanged through web forms and use of third party web based tools such as WhatsApp.

Cerbo Clinic will not be liable for improper use and/ or disclosure of confidential information (including Protected Health Information (PHI) that is the subject of the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA)).

Thus, if the patient/ legal guardian chooses to exchange Protected Health Information (PHI) with Cerbo Clinic through web based means (such as text messaging/ SMS, E-mail, Web Forms, Third Party Apps e.g. WhatsApp), patient or legal guardian must consent to the use of web-based tools for patient information.

Consent to the use of e-mail, text messaging, web form submissions, and use of Third Party communication tools includes agreement with the following conditions:

a. E-mails, text messages or other electronic communication to or from the patient/ legal guardian concerning diagnosis or treatment will be printed out and/or made part of the patient’s medical record. Because they are then a part of the medical record, other individuals who are authorized to view the medical record, such as staff and billing workforce members, will also have access to those e-mails.

b. The health care providers may forward e-mails, text messages or other web based communications internally to other staff or agents of the health care providers/ their practice as necessary for diagnosis, treatment, reimbursement, and other operations. The health care providers will not, however, forward e-mail or text messages or web form entries to independent Third Parties outside of Cerbo Clinic who are not involved with the patient’s treatment, reimbursement, or otherwise involved in their care, without the patient’s or legal guardian’s prior written consent, except as authorized or required by law. The health care providers may possibly forward e-mails, text messages, and other web based communications to other health care providers participating in the patient’s care.

c. Although the health care providers will try to read and respond quickly to an e-mail or text message or web form entry or WhatsApp message from the patient or legal guardian, the health care providers cannot guarantee that any particular message or e-mail will be read and responded to within any particular period of time. The usual period of time is one (1) business day, but it may take up to a week or longer if the person to whom the e-mail or message is sent to is away, or if the e-mail system or online communication system is not working. Thus, the patient or legal guardian should not use e-mail, text messaging, or web-based communications for medical emergencies or other matters that have to be handled quickly.

d. Text messages are used by health care providers for appointment reminders or to share more generic information. When text messages are sent by a patient or legal guardian there should not be an expectation of a response from the health care provider.

e. If the patient or legal guardian’s e-mail requires or invites a response from the health care provider, and the patient/parent/legal guardian has not received a response within a reasonable time period, it is the patient’s or legal guardian’s responsibility to call the practice in order to determine whether the intended recipient received the e-mail, and when the recipient will respond. As an alternative, the patient or legal guardian can discuss the issue by telephone.

f. The patient or legal guardian should not use e-mail or text messages or web forms or WhatsApp to discuss any subjects that the patient or legal guardian feels should be kept confidential, such as sensitive medical information regarding sexually transmitted diseases, AIDS/HIV, mental health, developmental disability, or substance abuse.

g. Where applicable, there may be a provider charge for the time necessary to respond to the e-mails and web based messages.

h. The patient or legal guardian is responsible for protecting his/ her password or other means of access to e-mail or text messaging or WhatApp. The health care provider or his/ her practice is not liable for information that is read by other people through errors caused by the patient or legal guardian or any Third Party.

i. The health care provider or his/ her practice cannot engage in e-mail or text message or other web based communication that is unlawful, such as practicing medicine across state lines. If through e-mail or text message or other online communication, the health care provider determines that an office or hospital visit is necessary to address the problem, or if the patient or legal guardian wants to have such a visit, it is the patient’s or legal guardian’s responsibility to schedule the appointment at the physical locations of Cerbo Clinic (Peninsula Office in Redwood City, CA or South Bay Office in San Jose, CA).

III. INSTRUCTIONS

To communicate by e-mail or text message or web form use or Third Party communication apps, the patient or legal guardian is advised to:

a. Limit or avoid use of his/ her employer’s computer. Information is often stored on the employer’s system and can be read by people within that organization.

b. Inform the health care provider/ practice of changes in e-mail, mobile phone numbers, or text messaging addresses.

c. Help the health care provider and practice to ensure that they are communicating about the right person, by putting the patient’s full name and date of birth in the body of the first e-mail message to the provider and/or practice and not in the subject line.

d. In order for the e-mail to be forwarded to the proper person, include the category of the communication in the e-mail’s subject line, (e.g., “I have a question to my neurosurgeon about my upcoming surgery” or “I need to reschedule my appointment” or “I have a question about my recent bill”). This helps us to respond to your queries more quickly.

e. Review the e-mail or text message to make sure it is clear and that all needed information is provided before sending to the health care provider or practice. E-mails from health care providers will be encrypted or sent through the PatientFusion portal for secure access.

f. The first time you receive an email you will get a notice email from PatientFusion and you will have to set up your user name and password with them. This user name and password will be required to access the first and all future emails.

g. Take precautions to preserve the confidentiality of e-mails or text messages, such as using screen savers and safeguarding computer passwords.

h. Withdraw consent only by e-mail or written communication to the health care provider and/or practice.

i. Contact the health care provider and/or practice at their provided telephone number with any questions about using e- mail or text messaging. This should be done before sending an e-mail to the health care provider and/or practice.

IV. PATIENT ACKNOWLEDGMENT AND AGREEMENT – INFORMED CONSENT

I acknowledge that I have read and fully understand the information Cerbo Clinic has provided me regarding the risks of using web based tools including e-mail, text messaging, web forms, and Third Party communication apps.

I understand the risks associated with the communication of web based tools including e-mail, text messaging, web forms, and Third Party communication apps between the health care provider and the practice and me, and consent to the conditions outlined in this document.

In addition, I agree to the above instructions, as well as any other instructions that Cerbo Clinic and Cerbo Clinic doctors may impose regarding web based communications including e-mail, text messages, web based forms and Third Party communication apps. 

My signature on the Patient Forms consent page confirms that I have read and agree with the above Communication Policy.