Information management issues affecting the maintenance of appropriate privacy for adolescents and the adults who care for them
From Rady Children’s in San Diego, an accounting of their experience going to default note sharing across most of the enterprise, including inpatient and specialty care. Main thrust of the article is that an opt-in strategy for providers does not result in much charing of notes, but opt-out does, and they know of no major issues with the practice.
An ethical analysis of cases involving adolescents and disclosure of sensitive information via patient portals. Offers suggestions for access policies.
[su_cite_pediatrics url_fragment = ‘141/6/e20172745’ author = ‘Bourgeois’ year = ‘2018’] | PubMed 29776979 | Author Search
Joint statement from the American Academy of Pediatrics Committee on Adolescence and Council on Clinical Information Technology regarding how electronic health records should support the special privacy needs of adolescent patients. Acknowledges the basic conflict between parent as the financially responsible party and the adolescent who may want certain kinds of care to be kept private from the parent. Proposes the creation of standards that could support more sophisticated modes of information transmission and display.
[su_cite_pediatrics url_fragment = ‘130/5/987’ author = ‘Blythe’ year = ‘2012’] | PubMed 23109684 | Author Search
Summary of a stance on adolescent confidentiality with respect to access to information in the adolescent’s chart. Contains links to relevant resources on this thorny topic.
Opinion piece that maintains that electronic health record patient portals be “designed to manage sensitive information, … able to differentiate between who is logging in and flex the data available to be viewed on the basis of the individual’s access type.” Avoids discussion of who decides what should be considered private and how the work of marking data sensitivity should be performed.
[su_cite_pediatrics url_fragment = ‘135/5/e1125’ author = ‘Bourgeois’ year = ”] | PubMed 25869372 | Author Search
An opinion piece on what is necessary in EHR systems to protect both the rights of the adolescent (to avoid unwelcome disclosure of sensitive health information) and the rights of the parents (to avoid unwelcome information about them to their child). While EHRs can be set up to segregate data in various ways, such segregation entails tremendous discipline on the part of clinical users to maintain this segregation and applicable laws to protect the clinician when access (by either the adolescent or the parent) is denied.
A focus-group study of adolescents’ expectations about health care information privacy, and other aspects of privacy in healthcare experiences. Adolescents felt strongly that their health information should be kept confidential from providers outside the encounter and (in the case of older adolescents) from parents. [su_cite_pediatrics url_fragment = ‘126/6/e1469’ author = ‘Britto’ year = ‘2010’]