Telemedicine Informed Consent In Utah: Requirements and Best Practices

The Utah Administrative Code requires clinicians to verify the patient’s identity and location prior to each telehealth encounter.

Informed consent is an integral part of telemedicine. Telemedicine and telehealth are often used interchangeably but are technically different in scope. Telemedicine specifically refers to the practice of medicine or the delivery of clinical services using telecommunications technology when the clinician and the patient are in different locations. In contrast, telehealth generally refers to a broader scope of remote services, including non-clinical services such as education, administration, and public health. While consent to telemedicine may seem implied and documentation of consent unnecessary, obtaining and documenting informed consent are good medical professional liability risk management practices and, in Utah, required by law.1

The Utah Administrative Code requires clinicians to verify the patient’s identity and location prior to each telehealth encounter.2 The Code also requires clinicians to obtain informed consent to the use of telehealth services by clearly disclosing:

    • Any telehealth fees billed separately from charges for any in-person services also being provided, and how payment shall be made;

    • To whom patient health information may be disclosed and for what purpose, including clear reference to any patient consent governing release of patient-identifiable information to a third-party;

    • Patients’ health information rights;

    • Appropriate uses and limitations of the service, including emergency health situations;

    • Information confirming that the telehealth services meet industry security and privacy standards, and comply with federal laws (HIPAA and HITECH);

    • Potential privacy risks notwithstanding security measures;

    • Risk of lost information due to a technical failure (refer to any patient consent to hold the provider harmless for such loss); and

    • The website owner/operator, location, and contact information.

During the COVID-19 declared state of emergency in Utah, clinicians who offer telemedicine services through a non-public facing platform (i.e., Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Zoom, or Skype) that does not meet HIPAA or HITECH standards must:

    • Inform the patient of that fact

    • Give the patient the option to decline using telemedicine

    • Take reasonable precautions to ensure security and privacy of the telemedicine visit3.

Whether required by statute or not, obtaining and documenting informed consent may prevent claims by patients who later allege they would not have engaged in telemedicine appointments had they known about certain risks or limitations. A good practice starts with a policy and procedure, so that everyone involved knows what to do and how to do it. The policy and procedure should include a comprehensive informed consent discussion prior to a telemedicine visit. Ideas for the policy include:

    • Outline key points for the clinician-patient discussion and incorporate information required by state statute, Executive Order, licensing board policy, or Medicaid rule;

    • Specify that clinicians should enter or write a detailed chart note documenting the elements of the discussion and noting the patient’s verbalization of consent (or refusal);

    • Develop a comprehensive telemedicine informed consent form for patients to sign before care and treatment begins. The form should include the information the clinician covers orally with the patient; and

    • Integrate the discussion and documentation into the workflow.

Informed Consent Discussion

Telemedicine is new to many. The clinician should explain the risks, benefits, and limitations of telemedicine and address patient responsibilities and expectations. Present the information in terms the patient can understand, so the patient can make an informed decision. The consent discussion process also may increase the patient’s comfort with new technology or the change from in-person to telemedicine appointments. Prior to providing telemedical care, physicians and other clinicians should present the following information4:

    • Basic explanation of telemedicine and the platform being used;

    • Benefits – including accessibility, cost savings, and efficiency;

    • Risk that a technical interruption could delay evaluation or treatment5;

    • Risk that the clinician’s medical decision-making and diagnostic ability may be compromised by the inability to conduct a comprehensive physical exam, lack of access to complete medical records, and/or inadequate image quality;

    • Risk of data breach even with the use of security protocols6;

    • Alternatives, such as in-person care;

    • Option to decline telemedicine or stop the visit at any time;

    • Patient responsibilities, which may include providing complete and accurate information, using a secure network and a private location, and complying with clinician recommendations such as follow up labs, diagnostic tests, referrals, or in-person visit;

    • Federal laws governing privacy and security of health information, as well as patient access to that information, apply equally to in-person and telemedicine care;

    • Confirmation of the state where the patient is located during the appointment;

    • Billing – confirm there will be a charge for the visit and that patient’s share of cost will be governed by their individual insurance coverage,

    • Discussion of the practice’s telemedicine no-show or cancellation policies; and

    • Opportunity for the patient to ask questions.


Document the informed consent discussion and the patient’s consent or refusal:

    • in the patient’s medical record; and
    • through a signed consent form (see Workflow, below), which may serve as additional contemporaneous evidence of the discussion and consent should there be resulting litigation or a medical board complaint.


Build the consent process into your telemedicine workflow. One idea is to develop a telemedicine consent package to send patients at the time of scheduling. The package could include the consent form and an information sheet explaining telemedicine and the practice’s telemedicine process in patient-friendly terms. An explanation before the appointment gives patients time to consider the information and think of questions to ask the clinician during the consent discussion. Providing information for a patient to digest ahead of time also can reduce the risk that a patient could later credibly allege that the physician “rushed” the patient through the consent process.

1 State Medicaid or workers’ compensation plans may impose additional requirements.

2 Utah Administrative Code R-156-1-602(2)

3 Utah Executive Order No. 2020-7 dated March 25, 2020. 

4 For more information about what to include in the consent discussion, consult the American Telemedicine Association’s Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interaction (p. 7, numbers 6-8); see also American Medical Association Ethics Opinion 1.2.12, Ethical Practice in Telemedicine, and Federation of State Medical Boards Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine

5 Clinicians should explain the procedure to follow if a technical interruption occurs.

6 Always inform patients whether the platform the practice is using meets HIPAA standards.

The content of this publication or presentation is intended for educational purposes only; is not an official position statement of Mutual Insurance Company of Arizona (MICA); and should not be considered or relied upon as professional, medical, or legal advice or as a substitute for your professional judgment. Consult your attorney about your individual situation and the applicable laws. The authors, presenters, and editors made a reasonable effort to ensure the accuracy of the information at the time of publication or presentation but do not warrant or guarantee accuracy, completeness, or currency of such information. As medical and legal information is constantly changing and evolving, check for updated information and consult your attorney before making decisions.

Similar posts

Subscribe to Our Monthly Newsletter, MICA Insider 

Sign up to receive new articles, free resources, and industry updates relevant to running an independent medical practice.