Stipulations and agreement for Tele Medicine service provided in ASQ

1. Tele Medicine service stiputations

1.1 Service description
Tele Medicine is supportive service at hospital, using telecommunication technology to increase convenience for service recipients of Bangkok Phuket Hospital Co., Ltd., or Bangkok Hospital Phuket. It encompasses consultation, diagnosis, treatment by the hospital’s doctors without those service recipients’ need to travel to the hospital.

1.2 Days and time of service
Monday – Sunday from 9.00 – 15.00 hrs., for service recipients with appointments only

1.3 Service delivering and service receiving

1.3.1 Service delivering
Bangkok Hospital Phuket provides Tele Medicine service for:
– Outpatients with medical history stored in the hospital’s medical records system, and with appointments made in advance
– Outpatients without medical history stored in the hospital’s medical records system and without any restrictions as to consenting to risk from service receiving as per Clause 2.2 and 2.3, whereby service requests have been lodged with appointment confirmation made in advance.

1.3.2 Service receiving
Tele Medicine service recipients will be provided with:

1.3.2.1 Doctors give consultation and diagnosis for their acknowledgement, encompassing the following:

– Findings
– Clinical diagnosis
– Treatment options
– Prognosis

1.3.2.2 Service recipients will be informed of prescribed medicine, dosage, side effects by doctors, nurses or pharmacists (varying from case to case).
1.3.2.3 Follow-up will be done within 1 day after the service delivered, i.e. nursing staff will call the patients by phone, monitoring arising symptoms.

1.4 Medical records handling
Over the course of Tele Medicine service, audio and video recording will be done as part of the hospital’s medical records.

1.5 How to get medicine
Service recipients will have it delivered to their doorsteps.

1.6 Service fees
Tele Medicine service has the following fees.

1.6.1 Hospital fees of 200 Baht per time
1.6.2 Doctor fees of 1,500 – 2,000 Baht per time, as part of consultation provided during Alternative State Quarantine (ASQ)
1.6.3 Medicine delivery fees of 1,000 per time, applicable to Phuket areas

1.7 Protection of personal data
Bangkok Hospital Phuket puts maximum emphasis on the protection of service recipients’ personal data. Confidentiality measures are enforced to the utmost in order to ensure the security of their personal data. They are recommended to turn on Letter Sealing function for increased confidentiality and integrity of their personal data.

1.8 Service restrictions

1.8.1 Tele Medicine service may prove to be of no use in case of a need to use certain specialized medical equipment or require hospital setting to perform certain diagnosis.
1.8.2 Consultation via Tele Medicine may have certain restrictions as to physical examination, resulting in certain inaccuracy in diagnosis or treatment.
1.8.3 Bangkok Hospital Phuket cannot issue a medical certificate following Tele Medicine service, with the exception of issuing it following consultation and continued medicine prescription in order to secure insurance coverage for medical treatment. All is subject to attending doctors’ discretion (a medical certificate will come along with medicine).

2. Service agreement for Tele Medicine
I, as the person who give consent, have thoroughly read the service stipulations of Tele Medicine as provided by Bangkok Hospital Phuket as per Clause 1 above. I shall thereby consent to such stipulations aforementioned, as well as to the following agreement.

2.1 I shall give consent for Bangkok Hospital Phuket to proceed in various manners as to my personal data, i.e. recording, storage, usage, disclosure or sharing with third parties as part of service delivering or data processing. This combines to increase my convenience in receiving services, or to align with the hospital’s prevailing standards and guidelines, as well as to further improve medical service standards.

2.2 Although Bangkok Hospital Phuket proceeds in compliance with all safety and security measures relating to service and personal data, risk may prevail on the part of service recipients. Should there be any risk on my part, I shall agree to notify the hospital immediately in such a way to rectify or indemnify it, as well as to improve and prevent such incident in the future.

2.3 I shall thereby take note of all risk that may prevail, and shall not claim or file any lawsuit civil or criminal, following such risk and consequences arising on my part as per Clause 2.2, unless the hospital fails to proceed up to their professional standards.

2.4 I shall agree not to withdraw this consent of mine over the course of Tele Medicine service by Bangkok Hospital Phuket.

How to give consent

1. The service recipient has to identify himself/herself with an ID card/passport every time.
2. He/she gives his/her consent by typing/clicking “acknowledge and consent”
3. Such consent with Bangkok Hospital Phuket shall be set forth as to prevailing mutual obligations and legal stipulations over the course of service delivered.