Authority: IC 25-22.5-2-7

Affected: IC 25-1-9; IC 25-22.5

Sec. 5. A written agreement must be employed documenting patient informed consent for the use of patient-physician e-mail. The agreement must be discussed with and signed by the patient and included in the medical record. The agreement must include the following terms:

1. (1) Types of transmissions that will be permitted, such as:

   1. (A) prescription refills;
   2. (B) appointment scheduling; and
   3. (C) patient education.
2. (2) Fees, if any, that will be assessed for on-line consultations or other electronic communication.
3. (3) Under what circumstances alternate forms of communication or office visits must be utilized.
4. (4) A statement that physician-patient e-mail is not to be used in emergency situations.
5. (5) Instructions on what steps the patient should take in an emergency situation.
6. (6) Security measures, such as encrypting data, password protected screen savers and data files, or utilizing other reliable authentication techniques, as well as potential risks to privacy.
7. (7) Hold harmless clause for information lost due to technical failures.
8. (8) Requirement for express patient consent to forward patient-identifiable information to a third party.
9. (9) Patient's failure to comply with the agreement may result in physician terminating the e-mail relationship.

(Medical Licensing Board of Indiana; 844 IAC 5-3-5; filed Oct 1, 2003, 9:32 a.m.: 27 IR 523; readopted filed Dec 1, 2009, 9:13 a.m.: 20091223-IR-844090779RFA; readopted filed Jun 16, 2010, 12:14 p.m.: 20100630-IR-844090779RFA; readopted filed Nov 22, 2016, 12:11 p.m.: 20161221-IR-844160317RFA; readopted filed Nov 22, 2022, 12:22 p.m.: 20221221- IR-844220255RFA; readopted filed Feb 27, 2024, 10:19 a.m.: 20240327-IR-844230772RFA)