Partners Online Second Opinions - Physician Consultation Request and Terms

Request for Online Second Opinion: I am requesting a Partners Online Second Opinion consultation with a Partners HealthCare System, Inc. (“Partners”)-affiliated physician.

Terms and Conditions of Participation: Partners Online Second Opinions (“POSO”) is a service offered by Partners. It is intended to allow you to request an online medical opinion consultation regarding your patient (a “Consultation”), to be provided by a Partners-affiliated physician. You hereby agree to abide by the full POSO Terms of Use posted at our website and incorporated herein by reference, as well as the terms set forth below.

The POSO service differs from in-person diagnostic services typically provided by a physician. The Partners-affiliated physician providing this service will not have the benefit of information that would be obtained by conducting an in-person exam of your patient and observing your patient’s physical condition. Therefore, the Partners-affiliated physician may not be aware of facts or information that could affect his or her opinion. In some cases, these facts may be critical to the opinion. You hereby acknowledge that you are aware of this limitation and agree to assume the risk of this limitation.

You further acknowledge and agree that:

1. The Partners-affiliated physician is only rendering a Consultation and does not assume any responsibility for my patient’s continued medical care or treatment.
2. My patient and I have discussed this request and understand the limitations of this service. I have received from my patient valid consent to access this POSO program on his or her behalf, which includes the right to release to Partners and Partners-affiliated physicians my patient’s medical records, information, and data, and to discuss my patient’s case with the Partners-affiliated physician.
3. A copy of the Consultation report will be made available to me through the POSO website and a courtesy copy may be made available to my patient. I will review the report with my patient and communicate and explain to my patient the Partners-affiliated physician’s opinion and recommendations as I deem appropriate, based on my professional judgment.
4. I am licensed to practice medicine where my practice is located and where I treat my patient. I agree to maintain medical records as required by applicable laws, including but not limited to appropriate and timely notes concerning the Consultation, documentation of my patient’s informed consent for the Consultation, and other legally required information. Partners will have access, at all reasonable times, to the medical records of my patients for whom such consults have been provided hereunder to the extent permitted by applicable laws and regulations.
5. I am covered by occurrence-based professional liability insurance and shall maintain such insurance for the duration of my treatment of my patient on whose behalf I am seeking this consultation. If I become aware of any professional liability claim involving one of my patients on whose behalf I have sought a Consultation, I shall notify Partners promptly.
6. I agree to indemnify, defend, and hold harmless Partners and its affiliates and their trustees, directors, officers, employees, contractors, agents, and Partners-affiliated physicians from and against any claims, demands, costs, or expenses (including reasonable attorney’s fees) to the extent arising from the negligence, reckless misconduct, or breach of obligation by me or my agents.

Disclaimer and Release: You hereby completely and irrevocably release Partners and its affiliates and their trustees, officers, directors, employees, contractors, agents, and Partners-affiliated physicians (collectively, the “Partners Released Parties”) of any and all errors and omissions, known or unknown, foreseen or unforeseen, knowingly or unknowingly, as well as all claims, actions or damages arising from or in connection with the Consultation, conclusions, diagnosis, or recommendations provided by Partners or Partners-affiliated physicians. Furthermore, you agree that the Partners Released Parties have no liability or responsibility for the accuracy or completeness of the medical information submitted to them or for any errors in its electronic transmission.

If you do not agree to the above terms and conditions, Partners will not be able to provide you and your patient with a Consultation, but your patient always has the option of traveling to a Partners-affiliated hospital or physician office for an in-person evaluation.

This agreement, as well as the POSO Terms of Use, shall be governed by the laws of the Commonwealth of Massachusetts, and exclusive jurisdiction and venue for any and all claims shall be Suffolk County, Massachusetts.

I HAVE READ AND UNDERSTOOD THE INFORMATION IN THIS AGREEMENT. BY CLICKING “I AGREE” BELOW, I AGREE TO THIS AGREEMENT AND THE POSO TERMS OF USE.