VIVIDOCTOR INFORMED CONSENT DOCUMENT
Fully understanding and agreeing to the contents of this document is essential to benefit from ViViDoctor’s services.
In case of any questions or doubts, please do not hesitate to contact ViViDoctor help desk at firstname.lastname@example.org or call +32 485 06 70 02
Telemedicine / Telehealth: Telemedicine / Telehealth (used interchangeably) is the use of telecommunication and information technology to provide healthcare remotely.
Video Visit: A video visit or a video consultation (VV) is defined as a form of consultation that occurs over internet via video and audio exchange between a patient and a care-giver. Video consultations is a sub-category of Telemedicine.
Written Questions: Written Questions (WQ) is defined as questions that you can ask on ViViDoctor platform in the form of written text to a care-giver. Care-givers will answer the question not immediately but after a period of time (usually within 24 hours).
Medical File: Your patient file residing in your hospital or a EHR software by your General Practitioner (GP). ViViDoctor does not access this information directly.
Health Data: Any data about your health, e.g: your symptoms, your prescription history, your medical device info etc…
Care-Giver: A licensed healthcare worker, e.g: a nurse, a specialist, a GP, …
Physician: A Belgian Licensed Doctor or Specialist.
Follow up: A further appointment with a patient in order to monitor the success of earlier treatment.
EHR: Electronic Health Record
GP: General Practitioner
Recip-E: Belgian Electronic Prescription System
Platform: ViViDoctor Mobile and Web Platform
3. Information Regarding ViViDoctor Telemedicine Services
A. Medical Services
ViViDoctor is a platform that provides Virtual Visits and Written Questions. Virtual visits can happen either on demand or on appointment. In the case of on-demand visits, a patient can not select a specific doctor – meaning that the consultation can only go through with a doctor that is already online. In case of having no doctors online, the patient may have to wait or withdraw.
ViViDoctor Physicians and Care-givers are licensed in Belgium.
You can only consult with the doctors that are members of ViViDoctor platform. If any doctor is not on the system, you can not use ViViDoctor to connect them.
ViViDoctor acts as an intermediate platform, and itself is not a healthcare organization. ViViDoctor helps its care-givers with technological support for video and text consultation, guidelines and methodologies but it does not intervene on the art and science of the care itself.
A ViViDoctor virtual visit is not meant to replace a physical visit, but rather to complement it.
During a video visit, the doctor has access to your medical information provided by you on the platform.
The care-giver may give you physical instructions for an examination.
ViViDoctor platform is not an emergency service. If you are having a medical emergency, call 112 immediately.
B. Prescriptions, Sick Notes and Reimbursement
ViViDoctor Physicians can prescribe you a medicine, wherever they see fit. You agree and understand that it is up to the consulting doctor if he/she agrees to prescribe you a medicine. Having a virtual visit with the physician does not guarantee a prescription.
A prescription can either be delivered via Recip-E or by post (additional fees may apply).
ViViDoctor doctors can issue Sick Notes, if they see fit. Note that a virtual visit with the physician does not guarantee a sick note.
ViViDoctor services are not reimbursed by INAMI/RIZIV. When using ViViDoctor services, you understand that it is at your own/private cost. Our doctors do not issue green papers.
C. Technical Information
ViViDoctor platform runs on the internet. Patients can access the platform via
- The native mobile app: iOS and/or Android. All permissions for accessing Microphone and Camera must be given to the application.
- The web browser: Mozilla Firefox and/or Chrome (recommended). All permissions for accessing Microphone and Camera must be given to the application.
For all environments, a high-fidelity internet connection is required to ensure a smooth visit experience. This usually means a strong WI-FI connection or 3G/4G/LTE with strong reception signal.
Medical File: ViViDoctor does not access any of your medical files.
Data Storage: ViViDoctor keeps your information as secure as possible on its own servers within EU. This information entails:
- Personal Data (name, surname, email)
- Date and time of your visits
- Symptoms you entered
- General Medical Profile (Blood Type, Gender, etc)
- Your previous and future bookings
- Your e-prescriptions
- Payment and Billing Info
ViViDoctor personnel does not have access to your healthcare information.
Security: ViViDoctor employs most reasonable practice known to its staff to ensure that your data is safe. However, as a patient you must:
- Make sure that your computer/mobile device is trojan/virus/malware free.
- Not use ViViDoctor services on networks that you do not trust
- If you notice any abnormalities, contact email@example.com immediately.
4. Patient Rights and Responsibilities
A. Your Rights
You can stop using ViViDoctor and its services any time, without reasoning, without losing your rights to any other care provider.
- At any point throughout a consultation, you can stop the treatment at your own risk.
- You can access application features without limitations.
- All ethical rules that govern a patient-care-giver relationship apply.
B. Your Responsibilities
As a patient,
- You should inform your care-giver and ViViDoctor platform up-to-date and correct information, in order to ensure a high quality of service in return.
- You should judge with your best abilities that your symptoms can be treated over the remote video visit. If you have doubts, opt for a physical visit instead.
- You should ensure your telemedicine transmission is optimal for a medical consultation. Keeping your room quiet and private is at best interest.
- You should ensure to understand, comply and respect the technical requirements outlined in section 3-c.
- You should treat your treating care-giver with dignity, respect and care. The care-giver has the right to stop any conversation if this condition is not met. All ethical rules that govern a patient-care-giver relationship apply.
C. Complaints and Claims
In case you have any complaints, claims or questions please contact ViViDoctor Helpdesk on firstname.lastname@example.org , we would be glad to help you further.
In case of disputes Belgian Courts are responsible and Belgian laws are applicable.
5. Risks and Benefits
Benefits of Telemedicine
ViViDoctor’s written questions and video visits can save your time off from work, your gas cost and the frustration of having to wait in the waiting room.
Furthermore, if you live far away, a remote connection is very convenient for accessing health services.
Risks of Telemedicine
As all parts of healthcare, telemedicine is not without risks:
- In rare cases, information transmitted may not be sufficient (low quality of transmission) in which case your doctor will inform you, or discontinue the service.
- Delays and interruptions might occur due to deficiencies and failures of the devices (your mobile device, your network connection, doctor’s network, doctor’s device, …).
- In very rare cases security protocols might fail causing a breach of privacy of personal medical information.
- In very rare cases, a lack of access to complete medical records may result in adverse drug interactions or allergic reactions or other judgement errors.
Limitations and 2-minute Rule
Because of the remote nature of Video Consultation, not all complications can be treated remotely. Within the first 2 minutes of your consultation your care-giver will decide to go forward with the consultation or not. These conditions are listed below, not limited to:
- The complication can not be treated remotely or is an emergency case.
- There are unforeseen barriers in communication (e.g language mismatch, technical glitches, etc.)
- Unethical code of patient / physician conduct.
- Any other reason physician sees fit.
In such a case, your conversation will be stopped and you will be fully refunded.
By signing this form or checking the box to agree the contents of this document, I attest that I have read this document thoroughly and I understood well of all the contents including: my rights, the risks, consequences and benefits, general concepts. I contacted ViViDoctor and/or my physician wherever necessary. That said, I authorize ViViDoctor and its appointed doctors to use telemedicine in the course of my diagnosis, treatment or medical advice.
Please keep a printed copy of this document for your records.