CLINIC INFORMATION: MONASHEE MEDICAL CLINIC, Rossland, B.C.

The Physicians, Nurse Practitioners, Nurses, Social Workers, Allied Health Care Workers, and Staff (“the Health Care Providers”) at the Monashee Medical Clinic have offered to provide the following means of virtual care (“the Services”):

1. Email
2. Text Messaging (including instant messaging)
3. Video Conferencing
4. Website/Portal

PATIENT ACKNOWLEDGMENT AND AGREEMENT:

I acknowledge that I have read and fully understand the risks, limitations, conditions of use, and instructions for use of the selected Services more fully described in the Appendix to this consent form. I understand and accept the risks outlined in the Appendix to this consent form, associated with the use of the Services when interacting with the Health Care Providers. I consent to the conditions and will follow the instructions outlined in the Appendix, as well as any other conditions that are imposed in relation to patients using the Services.

I acknowledge and understand that despite recommendations that encryption software be used as a security mechanism for virtual care tools, it is possible that some information and interactions may not be encrypted. Despite this, I agree to interact with the Health Care Providers using these Services with a full understanding of the risk.

I acknowledge that either I or the Health Care Providers may, at any time, withdraw the option of using the Services upon providing written notice. Any questions I had have been answered.

APPENDIX

RISKS OF USING VIRTUAL CARE TOOLS

The Health Care Providers will use reasonable means to protect the security and confidentiality of information sent and received using the Services (“Services” is defined in the attached Consent to use virtual care tools). However, because of the risks outlined below, the security and confidentiality of all virtual care tools cannot be guaranteed.

• Use of virtual care tools to discuss sensitive information can increase the risk of such information being intercepted by third parties.
• Despite reasonable efforts to protect the privacy and security of information communicated through virtual care platforms, it is not possible to completely secure the information.
• Employers and online services may have a legal right to inspect and keep electronic communications that pass through their system.
• Virtual care tools can introduce malware into a computer system, and potentially damage or disrupt the computer, networks, and security settings.
• Communications through virtual care tools can be forwarded, intercepted, circulated, stored, or even changed without the knowledge or permission of the Health Care Providers or the patient.
• Even after the sender and recipient have deleted copies of electronic communications, back-up copies may exist on a computer system.
• Communications through virtual care tools may be disclosed in accordance with a duty to report or a court order.
• Some video conferencing platforms may be more open to interception than other forms of videoconferencing.

IF THE EMAIL OR TEXT IS USED AS A VIRTUAL CARE TOOL, THE FOLLOWING ARE ADDITIONAL RISKS:

• Email, text messages, and instant messages can more easily be misdirected, resulting in increased risk of being received by unintended and unknown recipients.
• Email, text messages, and instant messages can be easier to falsify than handwritten or signed hard copies. It is not feasible to verify the true identity of the sender, or to ensure that only the recipient can read the message once it has been sent.

CONDITIONS OF USING THE SERVICES

• While the Health Care Providers will attempt to review and respond in a timely fashion to electronic communications such as emails, text messages, and instant messages, the Health Care Providers cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The Services will not be used for medical emergencies or other time-sensitive matters.
• If your electronic communication requires or invites a response from the Health Care Providers and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether the intended recipient received the electronic communication and when the recipient will respond.
• Virtual care is not an appropriate substitute for in-person or over-the-telephone communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed. You are responsible for following up on the HealthCare Provider’s electronic communication and for scheduling appointments where warranted.
• Electronic communications or recordings of virtual encounters concerning diagnosis or treatment may be printed or transcribed in full and made part of your medical record. Other individuals authorized to access the medical record, such as staff and billing personnel, may have access to those communications and recordings.
• The Health Care Providers may forward electronic communications or recordings to staff and those involved in the delivery and administration of your care.
• The Health Care Providers might use one or more of the services to communicate with those involved in your care.
• The Health Care Providers will not forward electronic communications or recordings to third parties, including family members, without your prior written consent, except as authorized or required by law.
• The Health Care Providers are not responsible for information loss due to technical failures associated with your software or internet service provider.

INSTRUCTIONS FOR USING THE SERVICES: TO USE THE SERVICES, YOU MUST:

• Reasonably limit or avoid using an employer’s or other third party’s computer.
• Conduct virtual care encounters in a private setting and using a secure device, where possible.
• Obtain the Health Care Provider’s consent prior to making any recording of the virtual care encounter.
• Inform the Health Care Providers of any changes in the patient’s email address, mobile phone number, or other account information necessary to communicate via the Services.

IF SERVICES INCLUDE EMAIL, INSTANT MESSAGING AND/OR TEXT MESSAGING, THE FOLLOWING APPLIES:

• Include in the message’s subject line an appropriate description of the nature of the communication (e.g. “prescription renewal”), and your full name in the body of the message.
• Review all electronic communications to ensure they are clear and that all relevant information is provided before sending to the Health Care Providers.
• Ensure the Health Care Providers are aware when you receive an electronic communication from the Health Care Providers, such as by a reply message or allowing “read receipts” to be sent.
• Take precautions to preserve the confidentiality of electronic communications, such as using screen savers and safeguarding computer passwords.
• Withdraw consent only by email or written communication to the Health Care Providers.
• If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not rely on the Services. Rather, you should call the Health Care Provider’s office or take other measures as appropriate, such as going to the nearest Emergency Department or urgent care clinic.