About iPostOp for Jefferson Health Patients

Jefferson Health, including its outpatient offices, has a program that can be used by Jefferson Health patients. The program is called iPostOp (the “Program”) and it is a health tool that helps close the gap between you and your provider. The Program is a free and secure application that encourages you to take control of your total health.

Participation in the Program. I am a Jefferson Health patient and have been invited to participate in the Program. I understand that as part of the Program, I have to download an app (“App”) onto my smartphone or log into a website (https://ipostop.app/) to monitor my health. I understand that my Jefferson Health doctors and care team members (“My Health Team”) will help me register for the Program to keep track of my postoperative care. Using this App, I will answer questions related to my post-operative care, (“My Symptoms”), as well as enter additional information at my own discretion into the App. My Symptoms and the other information that I enter in the App will be stored in the cloud that can be accessed and read by My Health Team at any time. However, I understand that My Health Team will not review My Symptoms on a regular basis. I further understand that My Health Team may not monitor other information that I may enter into the App. In addition, I understand that My Health Team can make a summary of My Symptoms using the App that can be available when I visit with My Health Team.
Program Benefits. I understand that using the Program may help me better report My Symptoms to My Health Team. I will be encouraged to share My Symptoms with My Health Team. I understand that using the Program and recording My Symptoms in the App is not the same as seeing my doctor, or receiving medical care and does not replace any medical guidance I receive from My Health Team. The Program may be used in addition to the care I will receive from My Health Team. It is my responsibility to follow up with my doctors regarding My Symptoms. Additionally, I understand that the Program has additional tools within the App to help me recover post-operatively, if I want to use the tools.
Program Risks. I understand that the App is available at my convenience but I should call My Health Team to report a medical problem or if I have signifi cant symptoms or concerns. Importantly, I understand I should not report medical emergencies in the App. If I am in a medical emergency, rather than contacting My Health Team, I will contact emergency response, 911, or go to my nearest emergency room. The Program is used via mobile device or web-based platform, which could have any of the typical issues that you can have when using mobile devices or web-based platforms, such as not being able to connect to wireless internet and low battery.
Alternatives. I understand that I do not have to participate in the Program or use the App to record My Symptoms. I understand that I can always communicate with my My Health Team through other means of communication, such as telephone or patient portal. I understand that if I do participate, I will be asked to answer questions and complete activities within the App by the associated due date.
Payment. I understand that I will not receive any money to use the Program. The Program, including the App, will be provided at no cost to me. However, I understand data and plan charges may be charged by my mobile service carrier when I use the App that I will be responsible to pay.
No Condition. I understand that there will be no consequences to me if I choose not to participate or if I decide to stop participating in the Program and using the Program App. My treatment at Jefferson Health will not be affected if I decide not to participate or not to continue in the Program. My participation in the Program is voluntary.
Expiration Date/Right to Revoke. I understand that my authorization shall not expire. I understand that I have the right to revoke this authorization in writing to a member of My Health Team and may do so any time. If Jefferson Health has used or disclosed My Symptoms or other Program data before receiving my revocation, I understand that neither I nor Jefferson Health and My Health Team can take back those uses or disclosures.
Health Care Record. A copy of this Authorization form will be put in my Jefferson health care record. I understand that My Symptoms may automatically be made a part of my Jefferson health care record. I understand that steps are taken to protect confi dentiality of My Symptoms in my App. I further understand that the App will be managed in a way to protect the privacy of my information. I understand that personal information included in the App could be seen by someone other than My Health Team on the rare occasion that there is a problem with the App. I may share My Symptoms in my App with additional individuals other than Jefferson employees or My Health Team. If I choose to share outside of My Health Team, Jefferson Health cannot and will not be expected to protect the privacy of my information.
Copy of Authorization. A copy of this Authorization will be available upon my request.
Authorization. I understand how Jefferson Health plans to use and disclose My Symptoms and data on the Program App. By signing below, I authorize Jefferson Health to use and disclose My Symptoms and data on the Program App for the purposes described in this authorization. By signing this form, I certify that Jefferson Health has answered all of my questions to my satisfaction and I knowingly, willingly and voluntarily agree to participate in the Program and allow Jefferson Health to use My Symptoms and data on the Program App for the stated purposes.

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