R156-1-602. Telehealth - Scope of Telehealth Practice

  (1) This rule is not intended to alter or amend the applicable standard of practice for any healthcare field or profession. The provider shall be held to the same standards of practice including maintaining patient confidentiality and recordkeeping that would apply to the provision of the same health care services in an in-person setting.

  (2) In accordance with Section 26-60-103 and Subsection 26-60-104(1), a provider offering telehealth services shall, prior to each patient encounter:

  (a) verify the patient's identity and originating site;

  (b) obtain informed consent to the use of telehealth services by clear disclosure of:

  (i) additional fees for telehealth services, if any, and how payment is to be made for those additional fees if they are charged separately from any fees for face-to-face services provided to the patient in combination with the telehealth services;

  (ii) 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;

  (iii) the rights of patients with respect to patient health information;

  (iv) appropriate uses and limitations of the site, including emergency health situations;

  (v) information:

  (A) affirming that the telehealth services meet industry security and privacy standards, and comply with all laws referenced in Subsection 26-60-102(8)(b)(ii);

  (B) warning of potential risks to privacy notwithstanding the security measures;

  (C) warning that information may be lost due to technical failures, and clearly referencing any patient consent to hold the provider harmless for such loss; and

  (D) disclosing the website owner/operator, location, and contact information; and

  (c) allow the patient an opportunity to select their provider rather than being assigned a provider at random, to the extent possible;

  (d) ensure that the online site from which the provider offers telehealth services does not restrict a patient's choice to select a specific pharmacy for pharmacy services.

  (3) In accordance with Subsection 26-60-103(1)(b), it is not an acceptable standard of care for a provider offering telehealth services to establish a diagnosis and identify underlying conditions and contraindications to a recommended treatment based solely on an online questionnaire, except as specifically provided in Title 58, Chapter 83, the Online Prescribing, Dispensing and Facilitation Licensing Act.

  (4) In accordance with Subsection 26-60-103(1)(c), a provider offering telehealth services shall be available to the patient for subsequent care related to the initial telemedicine services, by:

  (a) providing the patient with a clear mechanism to:

  (i) access, supplement, and amend patient-provided personal health information;

  (ii) contact the provider for subsequent care;

  (iii) obtain upon request an electronic or hard copy of the patient's medical record documenting the telemedicine services, including the informed consent provided; and

  (iv) request a transfer to another provider of the patient's medical record documenting the telemedicine services;

  (b) if the provider recommends that the patient needs to be seen in person, such as where diagnosis requires a physical examination, lab work, or imaging studies:

  (i) arranging to see the patient in person, or directing the patient to the patient's regular provider, or if none, to an appropriate provider; and

  (ii) documenting the recommendation in the patient's medical record; and

  (c) upon patient request, electronically transferring to another provider the patient's medical record documenting the telemedicine services, within a reasonable time frame allowing for timely care of the patient by that provider.

  (5) In accordance with Subsection 26-60-103(1)(d), a provider offering telehealth services shall be familiar with available medical resources, including emergency resources near the originating site.

  (6) In settings and circumstances where an established provider-patient relationship is not present, a provider offering telehealth services shall establish a provider-patient relationship during the patient encounter, in a manner consistent with standards of practice including providing the provider's licensure and credentials.

  (7) Nothing in this section shall prohibit electronic communications consistent with standards of practice applicable in traditional health care settings, including those:

  (a) between a provider and a patient with a preexisting provider-patient relationship;

  (b) between a provider and another provider concerning a patient with whom the other provider has a provider-patient relationship;

  (c) in on-call or cross coverage situations in which the provider has access to patient records;

  (d) in broader practice models where multiple providers provide care as a team, including, for example:

  (i) within an existing organization; or

  (ii) within an emergency department; or

  (e) in an emergency, which as used in this section means a situation in which there is an occurrence posing an imminent threat of a life-threatening condition or severe bodily harm.