How private is telehealth, really?

Many people turn to telehealth for privacy. If you are sexually active, need routine STI screening, or use medications you would rather not discuss with your primary care provider, telemedicine can feel like a more discreet option. No waiting rooms. No awkward conversations. No uncomfortable questions.

But there is a misconception that telehealth creates a separate medical universe that never connects to your electronic health record. In reality, keeping sexual health completely off your broader medical record is much harder than people realize.

This article explains what is and is not possible when it comes to privacy.

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Shameless Care and Electronic Health Records

Shameless Care operates outside the large, insurance-based electronic health record networks used by hospitals and health systems. Our physicians, our platform, and our partner pharmacies are independent from EHR systems like Epic or Cerner.

However, this does not guarantee that none of your telehealth activity will ever reach a system that could be accessed by an insurer, a physician, or another healthcare entity.

Here are several common ways information can be connected.

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1. STI Treatment Almost Always Appears on Pharmacy and Insurance Records

If you test positive for an STI through Shameless Care, your physician will prescribe the appropriate treatment.

That prescription is sent to the local pharmacy you selected, and the pharmacy will:

• automatically run the prescription through your insurance
• automatically attach the medication to your pharmacy record
• automatically transmit the claim to your insurer

This creates an unavoidable record trail connected to your electronic health record profile.

There is no way to submit an anonymous STI prescription to a retail pharmacy.

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2. Some STIs Require In-Person Care

Certain infections or symptoms require you to seek treatment at:

• urgent care
• an emergency room
• or another in-person, insurance-based provider

Any visit to an insurance-based clinic or urgent care will be recorded in that provider’s electronic health record system. If they test, diagnose, or treat you for an STI, that information becomes part of your EHR automatically.

Telehealth cannot prevent this.

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3. Mandatory STI Reporting Cannot Be Avoided

In all fifty states, if you test positive for certain STIs — such as chlamydia, gonorrhea, or syphilis — the diagnosing provider must report:

• your name
• your address
• your demographic information
• your diagnosis
• and your treatment

This information is transmitted to your local public health department.

Mandatory reporting applies regardless of whether you use insurance, pay out of pocket, or request privacy.

The only way to avoid mandatory reporting is never to get tested, which is not safe or recommended.

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4. Emergency Prescriptions Will Also Hit Pharmacy and Insurance Systems

Many Shameless Care patients request one-time prescriptions such as:

• a single dose of DoxyPEP
• treatment for a UTI

We are happy to provide these when clinically appropriate.

However, as soon as the prescription reaches your local pharmacy, it will be run through your insurance automatically. That interaction becomes part of your pharmacy claims record, which is linked to your broader EHR profile.

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5. You May Disclose Telehealth Use Yourself

Information can enter your electronic health record simply because you mention it during routine care.

For example:

• submitting Shameless Care receipts for insurance reimbursement
• discussing your telehealth prescriptions with your primary doctor
• using HSA or FSA funds that document the transaction

These are normal actions, but they can create additional records that connect telehealth activity to your broader medical file.

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What Telehealth Cannot Guarantee

No telehealth company can guarantee that all prescriptions and diagnoses will stay out of your electronic health records. There are simply too many ways the dots can be connected, as outlined above, including actions taken by the patient that are completely outside the control of the telehealth company.

This is not a flaw of telemedicine.

It is how the U.S. healthcare system works.

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What Telehealth Can Keep Private

Telehealth can keep the following internal and out of large medical systems:

• the detailed answers you provide in your intake
• your sexual history
• private conversations with your telehealth provider
• internal clinical notes
• data stored exclusively within Shameless Care’s secure system

These remain within our encrypted platform unless sharing is required by law.

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The Bottom Line

Telehealth greatly increases privacy compared to traditional care. It eliminates waiting rooms, removes uncomfortable interactions, and protects your dignity. But it cannot guarantee total invisibility within the broader healthcare ecosystem.

STI prescriptions, STI diagnoses, pharmacy claims, insurance processing, mandatory reporting, and even casual conversations with your regular doctor can all link telehealth activity to your electronic health record.

At Shameless Care, our commitment is transparency. We want you to understand how the system works so that you can make informed, confident decisions about your sexual health.