Are e-consultants covered entities?

The classification of e-consults under HIPAA depends on how they function within the healthcare organization. E-consults involved in direct patient care and billing are likely covered entities, while those managing PHI on behalf of covered entities are business associates.

What are e-consultants?

E-consultants are professionals who provide expert advice and services remotely, typically through digital platforms such as video conferencing, email, chat, or specialized consulting software. They operate in various industries, including healthcare, business, IT, marketing, and finance. 

“E-consultations are used in a variety of ways within and across medical centers. They provide timely access to specialty care and are well-received by primary care providers,” said Varsha G Vimalananda, summarizing the literature describing the use and effects of e-consults. They further said that "e-consults offer a rapid, direct, and documented communication pathway for consultation between primary care and specialist. They may avert the need for a face-to-face visit between specialist and patient. As a result, they have the potential to enable cost-effective and convenient care for patients while improving access to and coordination of specialty care across the system.”

Related: How HIPAA compliant email can improve healthcare access for rural patients

Are e-consultants covered entities?

• Yes, if they are healthcare providers (e.g., physicians, specialists) who transmit protected health information (PHI) electronically in connection with HIPAA transactions (like billing insurance).
• No, if they do not conduct electronic transactions covered by HIPAA.

Go deeper: What is a covered entity under HIPAA?

Are e-consultants business associates?

• If an e-consultant provides telehealth, second opinions, or medical guidance on behalf of a covered entity (e.g., a hospital or clinic), they may be considered a business associate and must comply with HIPAA.

Read also: How to know if you’re a business associate

Key factors to consider

• Is the e-consultant a licensed healthcare provider?
• Does the e-consultant bill insurance or handle PHI electronically?
• Is the e-consultant acting under a business associate agreement (BAA)?

See also: HIPAA Compliant Email: The Definitive Guide

FAQS

Can e-consultants store or access patient data?

Yes, but if they do, they must implement HIPAA compliant security measures, such as encryption and access controls, to protect patient information.

How do e-consultants impact healthcare access?

E-consultants streamline communication between primary care providers and specialists, reducing the need for in-person visits. This approach can improve patient access to care, reduce wait times, and lower healthcare costs.