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MY.MDANDERSON.ORG
Patient Information and Acknowledgment Form

PLEASE READ THE FOLLOWING INFORMATION CAREFULLY. YOUR CONTINUED USE OF THIS SITE AND RELATED SERVICES WILL INDICATE YOUR UNDERSTANDING OF THIS INFORMATION, YOUR AGREEMENT THAT YOU WILL FOLLOW ALL INSTRUCTIONS GIVEN, AND YOUR ACCEPTANCE OF THE RISKS AND TERMS OUTLINED BELOW. IF YOU DO NOT AGREE TO BE BOUND BY THESE TERMS PLEASE PROMPTLY EXIT THIS SITE.

Risks of Using Electronic Communication Systems, including Email
The University of Texas MD Anderson Cancer Center (hereafter "MD Anderson") offers patients the opportunity to use the my.mdanderson.org website to view general information, to view certain personalized information, to refer to patient education materials, to conduct selected transactions (e.g., refill a prescription with the MD Anderson pharmacy), to communicate by secure messaging, and to receive certain notifications by email.

Secure messaging is online electronic communication that takes place between various authorized parties within a secure website. Messages are sent, received and archived through the website, and Internet email is not required or used. Security and privacy are provided through encryption, the special digital encoding of data that can prevent unauthorized persons from reading the contents of protected messages. (Internet email is usually not encrypted and therefore is inherently not secure.)

MD Anderson is using industry-standard encryption technologies to protect and secure the my.mdanderson.org website, including the secure messaging function. Because of the added security of web-based, encrypted messaging, MD Anderson strongly recommends the use of secure messaging via the my.mdanderson.org website, instead of Internet email, for online communications between patients and providers.

However, the use of any electronic communication system such as the World Wide Web (including secure messaging) and email for patient-provider communications has a number of risks that patients should consider before use. Many of these risks apply to the use of electronic information in general; other risks apply particularly to email communications. These include, but are not limited to, the following risks:

Conditions for the Use of Electronic Communication Systems
MD Anderson will use reasonable means to protect the security and confidentiality of electronic information sent and received, including the use of encryption and other security technologies. However, because of the risks outlined above, MD Anderson cannot guarantee the security and confidentiality of web-based communications, and will not be liable for improper disclosure of confidential information that is not caused by MD Anderson's intentional misconduct.

It is also important to understand that mymdanderson.org was designed primarily to supplement and support your relationship and communications with your health care team, and to make it easier for you to conduct certain "routine", non-urgent interactions related to your health care and treatment at MD Anderson. mymdanderson.org is not intended to replace or to substitute for face-to-face meetings and/or personal conversations with your physician.

Thus, you must agree to and acknowledge the following terms when using electronic communications systems, including mymdanderson.org, to communicate and share your information with MD Anderson.
  • I understand that electronic communications will be read and responded to as promptly as possible; however, a specific turnaround time is not guaranteed. Thus, I will not use electronic communications for medical emergencies or other time-sensitive matters.
  • I acknowledge that some or all electronically transmitted information concerning my diagnosis and/or treatment may be made part of my medical record, and that it is up to my health care team to decide when this will happen. Because these communications become part of the medical record, other individuals authorized to access the medical record, such as my health care providers, other MD Anderson staff, or others to whom I specifically authorize disclosure of my medical record, will have access to my electronic information.
  • I am aware that my electronic information may be forwarded internally to other MD Anderson staff and agents as necessary for diagnosis, treatment, reimbursement and other business purposes. Electronic information will not, however, be forwarded to independent third parties without my written consent, except as authorized or required by law.
  • I understand that it is my responsibility to protect passwords or other means of access to electronic information. It is also understood that MD Anderson and its representatives are not liable for breaches of confidentiality caused by any third party or myself.
  • I acknowledge that it is my responsibility to follow up and/or schedule an appointment if warranted.
  • I acknowledge that it is my responsibility to follow up with a person to whom I have sent a secure message or email, if I have not received a response in a time frame that is acceptable to me.
  • I acknowledge that it is my responsibility to read and appropriately follow all communications sent to me by MD Anderson representatives.
  • I acknowledge that it is my responsibility to provide MD Anderson with accurate information about me, and that my health care team at MD Anderson will use some or all the information I provide, as they see fit, to make decisions about my diagnosis and treatment.
  • I understand and acknowledge that I may not receive a response from my health care team each time I communicate with them via electronic communication systems, including email; it is up to them to decide whether and when to send me a response.
  • I acknowledge that neither my.mdanderson.org nor any other use of MD Anderson's web site is a substitute for appropriate and timely contact with my health care team
  • I acknowledge that MD Anderson may discontinue this service at any time
  • I acknowledge that I will follow the instructions listed below, and other instructions that I may receive from MD Anderson from time to time, when I communicate by secure messaging or email with MD Anderson. I agree that I will:
    • Use secure messaging or email only to send messages regarding the following categories:
      • care information
      • clarification of patient instructions
      • information related to clinical trials
      • prescription re-fills
      • scheduling requests for follow-up clinic visits
      • billing and insurance questions.
    • Include key words relating to the subject of the communication in the electronic message's subject line.
    • Avoid or minimize use of computers widely accessible by others, such as an employer's computer.
    • Keep electronic messages short.
    • Review the electronic message before I send it to make sure it is clear and that all relevant information is provided
    • Review any email message before I send it to make sure that the "TO" field is properly completed.
    • Acknowledge receipt of an electronic message from the physician by sending a brief reply.
    • Take precautions to preserve the confidentiality of secure messages and email.
    • Not use secure messaging or email to transmit information or questions of an urgent nature, and in an emergency I will go to an Emergency Room and/or contact my health care team as I have been instructed in the past
Patient Acknowledgement and Agreement
I acknowledge that I have read and fully understand the information provided in this form. I understand the risks associated with using electronic systems to contact and receive information from MD Anderson. I agree to the terms listed above, in addition to the terms and conditions of the mdanderson.org Legal Statement and the mymdanderson.org Privacy and Security Policy. In addition, I agree to the instructions outlined herein, as well as any other instructions or that any MD Anderson representatives may create pertaining to electronic communications between MD Anderson and its patients. I understand that MD Anderson may discontinue this service at any time. Any questions I may have had were answered.

UNAUTHORIZED ACCESS TO THIS NETWORK DEVICE IS PROHIBITED. This system is for the use of authorized users only. Individuals using this computer system without authority, or in excess of their authority, are subject to having all of their activities on this system monitored and recorded by system personnel. In the course of monitoring individuals improperly using this system, or in the course of system maintenance, the activities of authorized users may also be monitored. Anyone using this system expressly consents to such monitoring and is advised that if such monitoring reveals possible evidence of criminal activity, system personnel may provide the evidence of such monitoring to law enforcement officials.