The net psychiatrist

Terms of service

Updated 20th of March 2014

Summary

* The service provides a connection to a psychiatrist.

* The primary purpose is to identify the causes of the clients symptoms and seek practical solutions to the problems.

* The net psychiatrist may prescbribe medication for clients that reside in European Union using the European prescription form always when sending the prescription to the client is secure. In Finland the prescriptions are usually carried out by phone prescriptions directly to the pharmacy that the client wants to use.

* The service provides no sick leave certificates unless specifically agreed with the client’s employer.

* The customer should take care of the malware protection on their own computer and be extremely careful in security matters.

* Video call connection will be carried out by using Vsee program or some other secure free video call service. Skype is not safe enough to deliver a video call in health care. To guide the client, if necessary, instructions are given in telephone .

* If necessary, phones, text messages and e-mail communications can be used.

* Payment is done before the service event with credit card or by online bank e-payment.

* Service event may be canceled 24 hours prior to the service event.

* Customer data may need to be forwarded outside of Finland due to the nature of the service and the service provider ‘s whereabouts.

* Service provider protects the privacy the customer with upmost care and the customer’s personal and medical records are kept safe and secure.

1 General Service

Online psychiatrist site is a health service that provides a connection to a  psychiatrist by video call, telephone, mobile phone or e-mail. The service is intended primarily to provide a client with a detailed recovery plan and carry it out. The service provider is an independent professional ( psychiatrist Juha Lehti ). Depending on the customer’s needs, the service is either 1) personal medical assessment and care (for example, assesment and treatment of insomnia) , or 2) general guidance to the health and well-being (for example, counseling the spouse of the patient suffering from sleep disorders) .

Online psychiatric service differs from the standard psychiatric care to some extent. Certain statements such as sick-leave certificates can not be written by the online psychiatrist ( unless there is a special agreement with the employer of the client). The net psychiatrist may prescbribe medication for clients that reside in European Union using the European prescription form always when sending the prescription to the client is secure. In Finland the prescriptions are usually carried out by phone prescriptions directly to the pharmacy that the client has chosen.

Online psychiatric service site provides health service but also the general level of information and advice on health issues. The database is free of charge and doesn’t aquire accepting the terms of use. However, in any case the visit to the site must be appropriate.

 2 Use of the Service

To use the service from the customer must be atleast 18 years of age and accept the terms of service. If you do not accept these terms, you may not use any parts of the service involving personal data , and / or personal health information , including credit card processing and online bank e-payment processing. You should not use the service in an environment where the service is not permitted. The Customer agrees that he or she does not give , and / or maintain a deliberately false or misleading information to the service provider.

All expences caused by internet security services that the customer may use on his/her computer are paid by the customer, as well as any other direct or indirect cost that a service that the customer uses such as text messages, phone calls or other electronic communications.

3 Video call, talk, telephone, mobile phone access and e-mail communication

The service event is carried out by a commercial or non-commercial video call service. Service may also include a phone contact, mobile phone contact , text message and / or e-mail communications. Since no Finnish health care authority nor Finnish information security authority has not yet formally identified which a video call services are safe enough for health services the service provider rates the the videocall secure if the video call service in general or based on expert judgment is judged to be safe and the video call service compliance with U.S. law (HIPAA compliance ). Skype is not sufficiently secure connection. Fixed telephony line, as well as a mobile phone connection and text messages are a secure enough way to communicate with the client and health care units according to Finnish law. In e-mail communication the service provider is oblidged using SSL technology protected e-mail address which is also recommended by the customer.

The primary video call service provider is VSee ( vsee.com ) . VSee services are estimated to be safe, they allow the compliance with U.S law (HIPAA compliance ) and they are free. If the client requests any other video call connection it may be used if it is usable and its security level is sufficiently high. The client may have to make a bilateral agreement with the video call service provider in which case the client is expected to follow compliance with the agreement.  Service Provider ( Online psychiatrist ) is not responsible problems or costs between the client and the video call service provider. The same applies to telephone operators, telecom operators, e-mail services, Internet access services, etc.

4 Payment Service

Service provider will charge the customer the price of the service (fee) before the service event. The amount of payment is determined by the service provider on the basis of the time spent in service event, which last 30 , 60 or 90 minutes. If the customer does not use the whole time he/she reserved , the fee is charged on the basis of the time reserved. If the time spent by the service provider exceeds the time reserved by the customer, the service provider is entitled to bill the customer depending on when the time has elapsed since the service event for every starting 30 minutes.

In the event that the customer has canceled his/her service event in an appropriate manner for at least 24 hours prior to the service event the customer is entitled to a full refund. If the customer cancels the service event later than 24 hours before the service start of the event the service provider will charge the customer from 50% to 100% of the original fee.

Service-related communications problems which are due mainly to the customer or his/her equipment and/or software (such as a broken or outdated computer software ) and that result in a service interruption, cancellation of or inferior quality of the service event the service provider is not obligated to return the fees. Service-related communications problems which are due mainly to service provider and lead to a significant problems of the quality of the service the service the service provider compensates the customer’s costs in a reasonable manner which may be a extension of the service event without extra payment, free service event the next time or a refund to the extent that the service has been missed out or it has been of low quality . Refunding issues in the communication problems which are independent of the customer and the service provider (for example a server failure) and that significantly interfere with delivery of the service are resolved primarly by negotiation in order to find a mutually acceptable solution but if one is not found the cost is cut in half between the customer and the service provider ( the customer pays 50% of the charge ). Short communications outages are possible in almost every electronic communication and the communication of short breaks is not considered to significantly decrease the quality of service assuming that the service event can be carried out as a whole in satisfactory manner.

The payment transaction is carried out by e-commerce application service provider (CheckOut).  E-commerce application service provider may collect personal information about the customer in which case handling and processing this data is based on the agreement between the client and the e-commerce application service provider and on the legislation. The service provider (Online Psychiatrist) is not liable to refund or compensate any problems to the extent that they are due to problems between the client and the e-commerce application service provider or one of them. Customer acknowledges that the fee-related problems can be repaired only after the payment even if a problem raises during the payment or before the payment.

The terms of the contract considering the payment will apply instatly when the event starts and the Finnish consumer protection act , Chapter 6, § 15 will not apply to the right of withdrawal .

5 Location of the service provider and the flow of information

The service provider is based in Finland and the website server is located in Finland. The service provider pays tax to Finland and pension contributions to Finland. The service provider may reside part of the year abroad in which case the service or its components are carried out to the client from abroad. Countries in which the service provider may reside in addition to Finland, and/or countries through which information may be transmitted are the Canada, United States and Panama. By accepting the terms of service the customer authorizes all personal and patient data transfers to those countries, and out of these countries within on-line psychiatrist service.

6 Rights

All the material contained on the site and the rights, copyrights, interests, patents and trade secrets of the site belong to the service provider. Customer acknowledges that the service does not give him/her access to any of these rights. However, the texts of the database of the site may be used as a reference for lawful purposes assuming that the source is acknowledged.

Service Provider reserves the right to refuse in certain situations a client or a specific IP address to use the service (eg security concerns) .

7 Data collected from the client and medical records

The service provider collects enough information of the client to shape a medical management plan for the client. Customer information collected are stored and handled carefully according to applicable laws and regulations. According to the law required the collection of information about the client includes the name , date of birth , social security number (if any) and contact information. The service privacy issues are presented in more detail in Chapter 8 and in Description of the privacy of patient data collection, processing and storage.

8 Data Protection Principles

The customer should be aware that the service deals with his health related information. This information does not belong to anyone. It is in the interest both the customer and the service provider that all information concerning the client is very carefully protected. Although protecting the information relating to health might seem like a trivial matter to customer service at the time of the service event protecting the information might later be important to the client.

The customer should maintain a high level of information security and personal data protection. This means that to computer or other device to use the service must have adequate virus and malware protection. Public PCs or other devices for public use are not recommended. The customer must carefully consider who is in the same permisses where the service is used. A good rule of thumb to keep in mind is: “Do not use the service in the presence of a person that you wouldn’t take to a psychiatrist with you.” To maintain a high level of security is for electronic mail service provider is required to use SSL encrypted e-mail address ( which is used by the service proviver) but a similar e-mail address is also recommended for the customer even if the law does not require the customer to have one. Examples of SSL encrypted e-mail services are Hushmail , Counter Mail, Bitmessage and NeoMailbox as well as the free source code based on GnuPG .

General principles of customer data storage and processing are:

The service is intended primarily to provide clients with the detailed management plan and a treatment period. When the treatment plan has been made and a the treatment has been carried out on a secure manner the service provider keeps as little information as possible about the client.
Client data is encrypted  and/or otherwise modified into a form that external persons or entities are not able to use or exploit the data.
As a rule any information about the customer is not given to anyone except the customer himself . If information is handed out to some third party (eg, follow-up care physician in charge ) by a permission of the client ( or his/her legal representative ) or by law then all data transfer situations follow “the principle of minimal disclosure of information” ie customer information released is so few and narrowly as possible – unless the customer otherwise do not want to – and the information is primarly transferred by the client himself to a third party so that the client has a possibilty to inspect the data that concerns himself.

9 Malpractice

The Customer agrees that he/she will not use the service or any part or service or other other internet sites or services connected with the service inappropriately nor encourage others in such activity. Inappropriate activities are: 1) the illegal use of the Internet site or parts of it, 2 ) giving or transferring illegal, obscene, defamatory, offensive, or falsified information/content, 3 ) a virus, malware or other harmful software/code transmission, 4) copying, modification or manipulation service or parts of it, 5) disturbing or complicating the service or parts of it, 6) distributing incorrect information about the service or parts of it or about the sites, services, persons or organizations that are connected to Onlinepsychiatrist.net -website, 7), storage and presentation of video calls, calls, or other communications with Onlinepsychiatrist.com services without the permission of the service provider . If the customer uses the service or parts of it or other sites or services linked to Onlinepsychiatrist.net in an inappropiate manner, the customer will reimburse to the service provider the direct and indirect costs and/or damages that the inappropriate activities have resulted.

10 Disclaimer

To use the service requieres from the customer sufficient ability to cooperate. The treatment plans, conclusions, advice and recommendations of the physician are based on the available data. Insufficient or incorrect information given by customer may lead to wrong conclusions. Allthough the service is sincerely designed to provide the customers with high-quality and detailed management plan and to provide the highest quality care the customer should be aware that plans, conclusions, recommendations and advice produced may be associated with sources of error.

11 Governing Law

Service is subject to the laws of Finland, excluding regulations conerning choice of laws. Service-related disputes are primarily resolved through negotiation, but if necessary, they are settled in Keski-Uusimaa District Court in Finland. The customer can make an appeal or complaint of the service and the treatment they have received to the Web site contact form, or they may address any complaints to the appropriate authority . Patient Injury Act (585/1986 as amended) shall apply to the possible extent.

12 Changes

Service Provider reserves the right to change the terms and conditions and/or discontinue the service or parts of it without prior notice. In this case, the previous terms and conditions bind the customer and the service provider to the extent that they have not been changed.

 

Description of the privacy concerning patient data collection, processing and storage

1 The data registry belongs to independent specialist in psychiatry Dr. Juha Lehti . Address: Seunalantie 30 A 10, 10 04200 Kerava .
2 The contact person in matters relating to data registry is Dr. Juha Lehti . Address: Seunalantie 30 A 10, 04200 Kerava .
3 The registry is called Netpsychiatrist patient registry .
4 The objectives of keeping the registry are: 1) to help plan and carry out treatment planning and treatment implementation , 2 ) quality control , 3 ) to archive, 4 ) facilitate statistical analysis and future planning of the service.
5 Data collected to the register: 1) The customer’s name , date of birth and social security number (if available) and contact information, 2 ) the health information of the patient that is needed to carry out analysis and tratment of the patient, 3 ) any other relevant information which is necessary to perform a good treatment.
6 Sources of Information : The customer.
7 Disclosure of Information : Due to the obligation of professional secrecy, in principle, any information of the customer will not be disclosed anyone. The exception of this rule is the client’s right to access to their own data when the client’s identity has been prooved in a reliable way. Patient data can also be disclosed to a third party (such as the unit responsible for follow-up care ) when such action has been authorized by the client by a separate consent, and when the law strictly obeys the servive provider to do so (Law of Patient Rights (785 /92) § 13 , the other 653/200 ). When the patient is situated in Finland public registers kept by Finnish authotrities to which a health-care unit as rule has to report certain patient data for research, planning and statistical purposes include: Register of Infectious Diseases, Health Care Register ( for example, malpractice etc), Register of children born ( maternity facilities) , termination of pregnancy and sterilization records ( hospitals) , Cancer registry , Congenital Malformations register and visual impairment register, as well as registers kept by Finnish Medicines Agengy (Fimea) which include the Drug side effect registry, Implant register and Narcotic medicines register. HOWEVER, DATA OF THE PATIENTS LIVING OUTSIDE OF FINLAND IS NOT SUBJECT TO THESE PUBLIC REGISTERS. With patient’s consent, or if the law so strictly dictates, information may be released to the insurance company. In all data transfer situations, the principle of minimal disclosure of information is applied which means that transferred customer information in as scarce and narrow as possible – unless the customer wishes otherwise – and the information is primarily transfered by the customer himself to a third party so that the customer has a possibility to inspect the data.
8 Customer information may be transferred outside of European Union and EEA . The customer accepts the transfer of the data by adopting terms of use which describes the principles of  thetransfer of data. The data transfer is necessary to run the service since part of the servers of the service are located outside of EU and EEA , and since the service provider may stay abroad for long periods of time. Information is not given to foreign authorities, companies, commercial or non- commercial entities or to other parties even if such authorities or entity demands it.
9 The use of patient data and the protection of the general principles are as follows. Laws of general principles : 1) Patient information is confidential . 2 ) Patient records may only be handeled by the service provider and by a person who is hired by the service provider and who is involved in patient care or related tasks and who has the right to the use of patient data. 3 ) The registry authority ( Dr Juha Lehti ) makes the administrative decisions concerning the registry and, if necessary, gives access to patient data to other people involved in the treatment , if it is in the best interests of the patient.
10 The patient register in electronic form and is handeled by the automatic data processing ( ADP ). Patient information that is in the electronic is protected by a username and password. Moreover, the patient information is very likely encrypted or otherwise encrypted with the storage. Patient records are accessible only to those authorized to so. Any paper documents that are created in addition to electronic patient records are stored in a locked and controlled facilities.
11 The customer has the right to inspect the information concerning him in the patient registry. The inspection is intended to implement without delay. The right of inspection may be refused only in exceptional cases when 1) providing the information could result in a serious risk to the health of the customer , 2) providing the information could significantly jeopardize the success of the treatment , or 3) provision of the information violates the rights of another person or might put another person in danger. The inspection is free of charge when it is done once a year or less frequently.
12 The request to inspect one’s own data in the patient registry is made by a document which is signed or otherwise authenticated and sent to the registry authority ( Dr. Juha Lehti ) , which will decide the right of inspection. Customer’s identity must be verified before the inspection by an ID with a picture. Information is handed by the registry authotrity ( Dr. Juha Lehti ) who makes a note to the patient data that an inpection has been done. The data are disclosed primarily in written form.
13 Patient data may be handed over to a third part by client’s permission and under certain circumstances by the concent of the the legal representative of the client. The client or his/her representative is required give voluntary, explicit and specific written consent for the disclosure of the information. The client or the legal representative of the client may at any time revoke the consent. Rare exceptions to the disclosure of information are: 1) If the disclosure is necessary for vital examination and care and the customer is unable to estimate reliably the consequences of giving or denial of the concent for exaple for severe mental illness, loss of consciousness, lovered level of consciousness or other similar reasons the information may be disclosed to another health care unit or health care professional without the consent of the patient. 2 ) For patients living in Finland no consent is required to the transfer the patient data when the law absolutely requires to disclose information.
The service requires the client to be of adult age but if a situation rises that there are patient data concerning a minor then such client may refuse to hand the patient data to his/her parents, guardians or other legal representatives if is obviuos that the patient can understand the meaning of denial of the data tranfer despite of his/her age. Loss of consciousness or a similar reason may justify the Service provier to give information about the client and of his state of health without the customer ‘s consent to the family of the client.