What is the purpose of this form?
The purpose of this form is to provide information to you about, and to obtain your consent to participate in, a telepractice consultation with your practitioner.
What is Telepractice?
Telepractice is the use of telecommunication to provide services to clients. The
practitioner typically uses videoconferencing to administer client sessions in real-time but may utilise other formats, such as email, for related communication. Telepractice is sometimes referred to as telehealth, telerehabilitation, or telespeech.
What does a telepractice consultation involve?
A telepractice consultation usually involves some or all of the following:
Your
practitioner will discuss your health and your health history with you and, where appropriate, will offer information and advice.
You may bring a support person with you, as you might in a face to face consultation.
If you attend a health service to participate in a telepractice consultation, other health professionals may be present and may need to examine you according to your
practitioner's instructions.
A technical support person might be present for part of the consultation to assist with technical issues.
You are not permitted to video or audio record the consultation, unless your
practitioner gives you permission to do so.
What are the potential benefits of telepractice?
Telepractice
might:
Improve access to services
Reduce your need for travel
Decrease exposure to infectious disease
What are the potential risks of telepractice?
Telepractice
might:
Be negatively impacted by technical problems, such as delays due to technology failures.
Not offer the same visual and sound quality for observations and modelling
Require someone onsite with you to support the
practitioner
Not feel the same as an onsite session
Not achieve everything that is required and therefore require another telepractice consultation or a face to face consultation.
Include practices and procedures that are not as well understood in a telepractice setting as they are onsite
Increase exposure to privacy and digital security risks. (See next section.)
Will my privacy be protected?
This practice is subject to the Privacy Act 1988 and must comply with obligations related to the collection, use and disclosure of personal information, including through telepractice. The
practitioner must maintain confidentiality and privacy standards during sessions, and in creating, keeping and transmitting records.
At times, audio and video recordings of sessions may be taken to support the
practitioner
’s work, as might occur in a face to face consultation. You will be informed before a recording takes place and can refuse to be recorded for any reason. The
practitioner will inform you of the reason for the recording and how it will be stored.
While the
practitioner
is obligated to meet standards to protect your privacy and security, telecommunication, including videoconference, may increase exposure to hacking and other online risks; as with all online activities, there is no guarantee of complete privacy and security protection. You may decrease the risk by using a secure internet connection, meeting with the
practitioner from a private location, and only communicating using secure channels.
What does informed consent mean?
There are a few important principles related to informed consent:
You must be given relevant information.
Ask the
practitioner if you have questions about telepractice and the services offered.
You have the right to understand the information.
Ask the
practitioner if you do not understand.
You have the right to choose.
If you do not agree to telepractice, you may refuse to participate. You may agree to or refuse specific activities and procedures.
You have the right to stop using telepractice at anytime.
You can change your mind about telepractice or a specific activity or procedure, even in the middle of a session.
You can agree or refuse in writing or verbally.
You may give your consent using the form below. You may also give consent or change your mind by telling the
practitioner
. Consent and refusal that you give verbally will be documented by the
practitioner.
You can ask about alternatives to telepractice.
I
f you refuse or change your mind about telepractice services, your
practitioner
will discuss any other options with you. The
practitioner may or may not be able to offer alternative services.