EHRs Pose Adolescent Confidentiality Risks

Researchers are concerned that electronic health records (EHRs) have the potential to breach confidentiality protections of adolescents who wish to keep sensitive health information private and inaccessible from their parents.

In adolescent healthcare, clinicians are trained to discuss issues such as sexually transmitted infections, pregnancy and birth control, and sexual orientation one-on-one with a teen, without the patient’s parents present. And in a paper records world, providers could easily flag this part of a patient’s record as private in the event that a parent requests to see their child’s records.

In the EHR era, however, while this type of information is gathered in the same way, now it is documented in an EHR and uploaded to a patient portal where parents could more easily access this information, researchers wrote in a recent article in the Journal of the American Medical Association. The cut-off age by which teens can elect to have their parents gain access to their online records can vary by facility, as Anne Tegen, MHA, RHIA, director of HIM at Children’s Hospitals and Clinics, in Minneapolis, MN, explained to the Journal last year.

“I know some hospitals that still maintain that information in paper because they can sequester it in a file,” Tegen said. “The record will let you know there’s a separate file. But that’s dangerous from my perspective, because how do you get access to that information when you really do need it?”

The authors also point out that because adolescents often are unable to pay for services or medications out of pocket, their parents could open explanation of benefits statements from insurance companies and providers after a service is rendered.

According to the authors, “Systems should be designed so that sensitive data from the adolescent are released to parents only after the adolescent consents. It is imperative to enunciate a clear standard of confidentiality that will protect both parents and adolescents.”

Read the JAMA article here, or click here for more on adolescent EHRs from the Journal of AHIMA.

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