LCOHPA Consent to Treatment Consent for Possible Telehealth Treatment

Definition of telehealth: Health care services provided through the use of information and communication technology by a health care professional, within the professional's scope of practice, who is located at a site other than the site the patient receiving the services. Please note: The patient receiving services must be located in a state in which the health care professional is licensed at the time of the treatment.
How do I use telehealth? Your appointment must be scheduled as a telehealth appointment and you must have an LCOH myChart account. If you do not have an account, go to the website and hover over “I want to” in the upper right and then click on “sign into myChart.” At least 10 minutes prior to your scheduled telehealth appointment, log into your LCOH myChart account and fill out necessary forms and click on your appointment. Sit in the virtual waiting room until your treatment provider joins the appointment.

If you participate in telehealth group therapy/treatment at LCOH, your appointment will be conducted via an LCOH Zoom license. Your treatment provider will provide you a Zoom link to log into these visits.

If you have any problems connecting at the time of your appointment, call LCOH outpatient scheduling at 513-536-0570 to notify someone who can notify your treatment provider. If you are experiencing an emergency or mental health crisis at any time that you are enrolled in telehealth treatment, call 911, go to your closest emergency room, or call the National Suicide Prevention Hotline at 1-800-273-TALK (8255).

What are the benefits of telehealth? You do not have to travel to the Lindner Center of HOPE to see your treatment provider. Therefore, treatment may be more convenient for you.

If you are ill, injured, or trying to prevent exposure to others who may be ill, you can receive treatment in the setting you choose. Please note: The patient receiving services must be located in a state in which the health care professional is licensed at the time of the treatment.

What are the risks of telehealth? You and your provider won’t be in the same room, so it may feel different than an office visit.

Your provider may make a mistake because they cannot examine you as closely as at an office visit. (We don’t know if mistakes are more common with telehealth visits.)

Your provider may decide you need an office visit at some times during your treatment.

Technical problems may interrupt or stop your visit before you are done. If this occurs, please try reconnecting to the video appointment. Alternatively, you can call 513-536-0600 or 513-536- 0570 to try to connect with your treatment provider by phone for the remainder of your appointment.

Will my telehealth visit be private? Telehealth visits are not recorded.

The same HIPAA regulations that apply to in-person visits apply to telehealth visits. This is a federal law that protects your privacy as a patient.

If people are close to you during your telehealth visit, they may hear something you did not what them to hear. You should be in a private place so other people cannot hear you.

Your provider will make sure that no one else from their office can hear or v see you during your telehealth visit.

LCOH uses telehealth technology through UC Health and a Zoom for Healthcare license that are designed to protect your privacy and are HIPAA compliant.

When you use the internet for telehealth, use a network that is private and secure.

As with any technology, there is a very small chance that someone could use technology to hear or see your telehealth visit.

Patient responsibilities for telehealth visits:

The patient must, at the time of the telehealth appointment, be located in Ohio or a state in which their treatment provider has a license to practice.

The patient must have a working cell phone, tablet or computer with a functioning camera and microphone, and reliable internet.

The patient must log into LCOH myChart in advance of the appointment (generally at least 10 minutes) and complete necessary forms before clicking on the appointment and waiting in the virtual waiting room for their provider to join the appointment. If attending group therapy, the patient must log on at the time of their appointment using the Zoom link sent by their treatment provider.

I understand the information included in this document and I have had the opportunity to ask questions about it. I will be provided a copy of this document after signing it.

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