Eight studies to know that Becker’s has reported on since Dec. 1: 

1. The Agency for Healthcare Research and Quality found that roughly 370,000 patients per year may be harmed as a result of misdiagnosis in U.S. emergency departments. 
2. A study conducted by Boston-based Harvard Medical School found that using telehealth can reduce primary care spending through lower emergency department utilization and inpatient hospitalizations. 
3. The New England Journal of Medicine published a study regarding two new defibrillation methods improving survivability and neurological outcomes.  

4. Epic Research reports that most telehealth visits don’t require an in-person follow-up visit.
   
5. Researchers at Ann Arbor-based University of Michigan found the number of “high intensity” bills for emergency room patients is on the rise.
   
6. Boston-based Harvard Pilgrim Health Care Institute conducted a study showing how socioeconomic factors drive telehealth service disparities. 

7. The Journal of Pediatric Surgery reports that children of color are less likely to have elective surgeries.
   
8. A recent study in JAMA found that medical terminology used by physicians often confuses patients, affecting care.

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AHRQ has created a sample telehealth consent form (Word, 27 KB) that is easy to understand. The form includes language for healthcare providers that have curtailed in-person visits due to COVID-19. AHRQ has also created how-to guidance for clinicians on how to obtain informed consent for telehealth.

Why should we use easy-to-understand telehealth consent forms?

Some States do not require documented informed consent for telehealth, but there are still advantages to using the AHRQ Easy-to-Understand Telehealth Consent Form.

• Clinicians can use the easy-to-understand language from the form when they are having the consent discussion.
• Clinicians can use the form as a checklist to make sure they have covered all the information required by informed consent rules.

Can we use the AHRQ Easy-to-Understand Telehealth Consent Form as is?

No. The AHRQ Sample Consent Form must be adapted before using it.

• Fill in the areas highlighted in yellow.
• Tailor the form. What is unique about your organization and your target audience?
• Put your logo on the form.
• Check with your lawyer before using the form. Laws on informed consent vary from State to State.
• Translate the form into languages your patients are most comfortable reading. Take care that translated materials are not made more complex.

How do we document consent when we’re not having the consent discussion face-to-face?

Patients can give their consent verbally at the beginning of their first telehealth visit, and clinicians can document it in the medical record. In addition to verbal consent, a signature can be obtained through your patient portal and the U.S. mail. Guidance on documenting consent is included in the how-to guidance for clinicians.

• You can arrange for patients to be able to virtually sign the consent form in your patient portal, if you have one. Clinicians will have to check whether patients can access the patient portal, and a staff member will have to give them clear directions on how to sign the form.
• If patients cannot use a patient portal, you can mail consent forms (one to sign and return, one for the patient to keep) and a stamped return envelope. Clinicians can ask patients to sign and mail back the form.

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The purpose of consent forms is to document that a discussion took place and that the patient was informed and was able to understand the information provided.

Before the consent discussion

• Mail or use your patient portal to send the form in advance, so patients can review it ahead of time.
• Arrange for a qualified interpreter if your patient does not speak English very well. Use the interpreter for the entire consent discussion.

During the consent discussion

• Use the consent form as a checklist to make sure you discussed all the information required by informed consent rules.
• Use easy-to-understand language.
• Use the teach-back method to confirm patient understanding.
  • Document teach-back with the Telehealth Consent Teach-back Documentation sheet (Word, 19 KB).
  • Start with a phrase like, “It’s my job to explain things clearly. To make sure I’m doing a good job, I ask every patient to tell me what you understand about telehealth and how it might help you.”
  • “Chunk and Check.” Don’t wait until the end to start teach-back. Chunk out information into small segments and have your patient teach it back. For example, ask patients, “Could you tell me in your own words what will happen to you if you decide you don’t want a telehealth visit?” Repeat several times during the discussion.
  • Clarify and check again. If teach-back uncovers a misunderstanding, explain things again using a different approach. Ask patients to teach-back again until they are able to correctly describe the information in their own words. If they parrot your words or read the form back to you, they may not have understood.

Before asking patients if they agree to a telehealth visit

• Ask patients if they have questions. You could say, “We covered so much information, I’m sure you have questions. What would you like to hear more about?”
• Avoid asking questions that will elicit yes and no answers, such as, “Do you have any questions?” and “Do you understand?”
• Offer to read the form aloud to all patients. For example, you could say, “I’d like to read aloud a summary of our talk about telehealth.”

After the consent discussion, document it

• Document patients’ ability to teach the information back correctly in the medical record.
• If patients do not consent, note it in their medical records.
• If patients consent:
  • Mail them a copy of the consent form to keep.
  • Obtain patients’ consent verbally and note it in the medical record. If you need a signed form, use your patient portal or the mail to get a signature.
    • If patients can sign the consent form in your patient portal, ask whether they are able to access the portal. If they are, direct them to staff who can walk them through how to consent online.
    • If patients can’t use the patient portal, mail consent forms (one to sign and return, one to keep) and a stamped return envelope, and ask patients to sign and mail back the form.
    • You do not need to wait to get a consent form signed. You can have telehealth visits with your patients based on their giving their consent verbally.

Telehealth Consent Teach-back Documentation

Name of Patient: _____________________________________________ Date: _____________

Name of Clinician: _____________________________________________________________

Name of Interpreter: ___________________________________________________________

(If patient does not speak English very well, use an interpreter)

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