Teen privacy poses a problem in patient portals

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The easy access to patient information that portals provide also comes with some sticky HIPAA privacy issues--including how much information teens' parents should be allowed to view.

"Some minors have their parents or guardians as their representative who have the right to access their information through HIPAA, but they may be able to consent to some services--sexual health services, substance abuse treatment--on their own. Then the parent or guardian does not have the right to see the information," privacy attorney Adam Greene, a partner at law firm Davis Wright Tremaine, says in an interview at HealthcareInfoSecurity.

In a state that allows a 17-year-old to obtain reproductive health services without parental consent, disclosing that information to a parent through the portal could be a HIPAA violation, he explains.

He foresees providers enacting different policies for three age groups: those 18 and over, whose parents should not have any rights to their information unless the child has authorized release of information to the parent; those 12 and younger who will not be able to consent to any healthcare services on their own, so parents should have access to all their information; and the in-between group where, depending on the state, parents have the right to see most of the information, but not some.

"There's no one-size-fits-all solution for how you're going to address that age group," he says.

Some organizations might give parents access to the portal but be able to segregate so that some information is not accessible. Other healthcare providers may not have that ability.  They might have to completely exclude information from this age group unless the minor signs an authorization for the parent to see any information the provider has.

"It could be that at age 13, the minor's health information is not available to the parent [through the portal] because you're not able to [segregate]. … This can also lead to some very challenging conversations between healthcare provider, minor and a parent asking for such an authorization," Greene says.

A study of teens in a California juvenile detention center found them overwhelmingly interested in being able to access their health records online. While the majority were willing to share their personal health histories with physicians, only half were willing to share their health records with parents.

Though texting has been found an effective way to communicate with teens in many cases, some providers won't send texts to young patients because the messages not encrypted for security, and the texts could be seen by someone other than the patient.

A study reported just this week, however, found that diabetic patients who used a patient portal to refill their prescription cholesterol medication improved their medication adherence and cholesterol levels compared with those who never used the portal.

To learn more:
- find the interview

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