Standards for Health Information Technology to Ensure Adolescent Privacy

Blythe, Margaret J.; Adelman, William P.; Breuner, Cora Collette; Levine, David A.; Marcell, Arik V.; Murray, Pamela J.; O’Brien, Rebecca; Beccaro, Mark A. Del; Schneider, Joseph H.; Weinberg, Stuart T.; Alexander, Gregg M.; Drummond, Willa H.; Francis, Anne B.; Handler, Eric G.; Johnson, Timothy D.; Kim, George R.; Leu, Michael G.; Tham, Eric; Zuckerman, Aland E.

doi:10.1542/peds.2012-2580

Cited by 70 publications

(11 citation statements)

References 10 publications

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“…Several EMR features pose threats to confidentiality, such as automated insurance claim generation, facilitation of clinical information exchange, and online patient/parent access. There are currently no universal standards for EMR systems regarding access to a young person’s record or disclosure of protected information with electronic billing [124–126]. Recent position papers of the Society for Adolescent Health and Medicine recommend that standards for EMR systems should include customizable, granular privacy controls to limit parent/guardian access to AYAs’ confidential information and the ability to prevent billing information and other e-notices about confidential services (e.g., visit reminders, e-prescriptions) from being sent to parents [124,126,127].…”

Section: Resultsmentioning

confidence: 99%

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Harris

Aalsma

Weitzman

et al. 2017

Journal of Adolescent Health

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We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act’s provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology—such as gaming platforms, mobile phone applications, and wearable devices—suggests opportunities to expand clinicians’ reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.

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Section: Resultsmentioning

confidence: 99%

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Harris

Aalsma

Weitzman

et al. 2017

Journal of Adolescent Health

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“…Protecting confidentiality for STI care, particularly for adolescents enrolled in private health insurance plans, presents multiple problems. After a claim has been submitted, many states mandate that health plans provide a written statement to the beneficiary indicating the service performed, the charges covered, what the insurer allows, and the amount for which the patient is responsible (i.e., explanation of benefits [EOB]) (166)(167)(168)(169). In addition, federal laws obligate notices to beneficiaries when claims are denied, including alerting beneficiaries who need to pay for care until the allowable deductible is reached.…”

Section: Cervical Cancermentioning

confidence: 99%

Sexually Transmitted Infections Treatment Guidelines, 2021

Workowski¹,

Bachmann²,

Chan³

et al. 2021

MMWR Recomm. Rep.

1,588

2,621

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These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019. The information in this report updates the 2015 guidelines. These guidelines discuss 1) updated recommendations for treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; 2) addition of metronidazole to the recommended treatment regimen for pelvic inflammatory disease; 3) alternative treatment options for bacterial vaginosis; 4) management of Mycoplasma genitalium; 5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testing among pregnant women; 7) one-time testing for hepatitis C infection; 8) evaluation of men who have sex with men after sexual assault; and 9) two-step testing for serologic diagnosis of genital herpes simplex virus. Physicians and other health care providers can use these guidelines to assist in prevention and treatment of STIs. BOX 1. The Five P's approach for health care providers obtaining sexual histories: partners, practices, protection from sexually transmitted infections, past history of sexually transmitted infections, and pregnancy intention Additional information about external condoms is available at https://www.cdc.gov/condomeffectiveness. Internal CondomsCondoms for internal vaginal use, also known as female condoms, are available worldwide (e.g., the FC2 Female Condom, Reddy condom, Cupid female condom, and Woman's condom) (31,32). Use of internal condoms can provide protection from acquisition and transmission of STIs, although data are limited. Internal condoms are more costly compared with external condoms; however, they offer the advantage of being controlled by the receptive partner as an STI and HIV prevention method, and the newer versions might be acceptable to all persons. Although the internal condom also has been used during receptive anal intercourse, efficacy associated with this practice remains unknown (33). Additional information about the internal condom is available at http://www.ashasexualhealth. org/pdfs/Male_and_Female_Condoms.pdf. Cervical DiaphragmsIn observational studies, diaphragm use has been demonstrated to protect against cervical gonorrhea, chlamydia, and trichomoniasis (34). However, a trial examining the effect of a diaphragm plus lubricant on HIV acquisition among women in Africa reported no additional protective effect when compared with the use of male condoms alone. Likewise, no difference by study arm in the rate of acquisition of chlamydia, gonorrhea, or herpes occurred (35,36). Diaphragms should not be relied on as the sole source of protection against HIV and other STIs.

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“…Compliance with federal regulations, such as the 21st Century Cures Act, and state-specific consent and confidentiality laws for adolescents requires a reliable mechanism to share protected health information with adolescents without guardian knowledge. Pediatric institutions often rely on separate adolescent portal accounts with differential information access for this purpose, as recommended by several national organizations . Our study suggests that this practice may be insufficient to fully protect adolescent confidentiality.…”

Section: Discussionmentioning

confidence: 93%

“…Pediatric institutions often rely on separate adolescent portal accounts with differential information access for this purpose, as recommended by several national organizations. [20][21][22] Our study suggests that this practice may be insufficient to fully protect adolescent confidentiality. We hypothesize several possible reasons for guardian access of adolescent portal accounts: (1) institutional workflow issues, including errors during portal sign-up 23 ; (2) misunderstanding of portal account design by adolescents and their a The estimated prevalence of guardian access to adolescent portal accounts after correction for algorithm performance is listed.…”

Section: Discussionmentioning

confidence: 96%

Assessment of Prevalence of Adolescent Patient Portal Account Access by Guardians

Yang

Parker

et al. 2021

JAMA Netw Open

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Key Points Question How frequently are adolescent patient portal accounts accessed by guardians? Findings In this cross-sectional study including 3429 adolescent accounts across 3 academic institutions, analysis of portal messages found that more than half of adolescent patient portal accounts with outbound messages were accessed by guardians. The percentage of accessed accounts was greater in children aged 13 to 14 years vs those aged 17 to 18 years. Meaning These findings may be useful in guiding health system approaches to protecting adolescent confidentiality when sharing health data via patient portals.

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Standards for Health Information Technology to Ensure Adolescent Privacy

Cited by 70 publications

References 10 publications

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Sexually Transmitted Infections Treatment Guidelines, 2021

Assessment of Prevalence of Adolescent Patient Portal Account Access by Guardians

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