Sunday, March 28, 2010

Informed Consent an Issue

The Policy Committee of the North Carolina Medical Board is continuing to discuss the state’s proposed policy on telemedicine. The Committee approved a draft telemedicine policy statement in January, but the full Board asked the Committee to continue to review the proposed policy to specifically clarify the “informed consent” language. On March 17th, the Policy Committee met and discussed the feedback received from a number of stakeholders on the issue of informed consent.

The informed consent statement in the draft statement reads “The physician using telemedicine should obtain the patient’s informed consent before providing care via telemedicine services. In addition to information relative to treatment, the patient should be informed of the risks and benefits of being treated via telemedicine. This includes how to receive follow-up care or assistance in the event of an adverse reaction to the treatment or in the event of an inability to communicate as a result of a technological or equipment failure. The patient retains the right to withdraw his or her consent at any time.”

During the Board’s consideration of the statement on informed consent, several radiology groups contacted the Board to voice concern over informed consent. They were concerned that this position statement in the document would require them to obtain an additional informed consent from patients when in the past they had traditionally relied on the informed consent obtained by the hospital or physician requesting the interpretation.

The Board does not intend to create such an additional requirement. In the event that radiologists or other specialists have traditionally relied on the informed consent obtained by another provider, the Board believes that such informed consent should remain sufficient.

The Board does caution that physicians relying on such informed consent and hospitals obtaining such informed consent may want to review such informed consents to ensure that they include the possibility that the patient’s diagnosis or treatment may be obtained by electronic communication, information technology, or by other means.

In March, the Board reviewed all of the comments and it was the consensus that the proposed informed consent statement should stand. However, after further consideration, the Board decided to table the issue until the staff could obtain additional information regarding informed consent.

Go to to download the statement on telemedicine. Topics addressed in the statement other than informed consent include staff training, examinations, physician-patient relationship, medical records, licensure, and fees.