(2016). National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Retrieved July 9, 2013, from http://www.aclu.org/FilesPDFs/med_privacy_guide.pdf. Ford, C., Millstein, S., Halpern-Felsher, B., & Irwin, C. (1997). The present voluntary, anonymous online survey was available for data collection over 14 days in March 2012 at the Alberta Childrens Hospital in Calgary (Alberta). English, A., & Park, M. (2012). Examiner les connaissances et les pratiques des dispensateurs de soins de lAlberta Childrens Hospital de Calgary, en Alberta, et tayer les pratiques au sujet du droit des adolescents la confidentialit. Zabin, L., Stark, H., & Emerson, M. (1991). Access to reproductive healthcare specifically is a major tenet of confidential adolescent care. Weiss, C. (2003). Beginning in early adolescence, HCPs should spend at least part of each health visit alone with an adolescent patient to convey that this is routine and valued health care practice. Retrieved 2013, from http://www.cdc.gov/hiv/resources/factsheets/PDF/youth.pdf, Centers for Disease Control and Prevention, & Vital Signs. Clinical preventive services for adolescents: Position paper of the Society for Adolescent Medicine. HCPs are discouraged from asking in the presence of a parent or caregiver whether an adolescent would like time in private, because the adolescent may feel uncomfortable with, or even reluctant, to agree. Washington, DC: Office of Juvenile Justice and Delinquency Prevention. Canadian Medical Association. the contents by NLM or the National Institutes of Health. Within these categories were two subgroups of opportunity versus intention and myth versus fact, which were aligned with three levels of responsibility, ranging from individual to team to institution. Medical decision-making in paediatrics: Infancy to adolescence. 2023 Apr 1;151(Suppl 1):e2022057267K. http://dx.doi.org/10.1097/AOG.0000000000003770. Ethics approval was obtained from the University of Calgary Conjoint Health Research Ethics Board. Confidentiality for individuals insured as dependents: A review of state laws and policies. JAMA, 282(23), 22272234. State policies in brief: Minors access to STI services. 2-4 Additionally, ensuring young people have access to . HCPs are discouraged from asking in the presence of a parent or caregiver whether an adolescent would like time in private, because the adolescent may feel uncomfortable or reluctant to, agree. to maintaining your privacy and will not share your personal information without Obstet Gynecol. State minor consent laws: A summary (3rd ed.). Clinicians providing adolescent care must understand the importance of confidentiality, its limits, and strategies to best facilitate delivery of confidential care in the practice setting. Journal of Adolescent Health, 38(3), 230236. Archives of Pediatrics and Adolescent Medicine, 154(9), 885892. Elk Grove Ill: American Academy of Pediatrics. (1990). Family members or caregivers might also believe that an adolescent feels comfortable discussing sensitive topics in their presence, and they may wish to be present to help intervene if something negative is impacting their adolescents life. The need to establish and guarantee a private environment is a leading priority for HCPs using telemedicine [32]. Hosp Pediatr 2015;5(2):67-73. American Academy of Pediatrics; Committee on Adolescence. As a library, NLM provides access to scientific literature. Thompson LA, Martinko T, Budd P, Mercado R, Schentrup AM. A legal and policy framework for adolescent health care: Past, present, and future. Even when the law explicitly protects the confidentiality of health information for adolescents, it may be permissible or even necessary to breach confidentiality in certain circumstances. 3Mount Royal University, Calgary, Alberta. Office of the Privacy Commissioner of Canada. American College of Obstetricians and Gynecologists. Patient portals available on most EHR platforms allow patients or caregivers to access to health information, including test results, diagnoses or problem lists, medications, and upcoming appointments. 14. Teens and mobile phones. doi: 10.1016/j.jadohealth.2012.08.003, S1054-139X(12)00335-7 [pii]. Chapel Hill, NC: Center for Adolescent Health & the Law and National Adolescent and Young Adult Health Information Center. J Adolesc Health 2014;54(4):487-90. Anoshiravani, A., Gaskin, G. L., Groshek, M. R., Kuelbs, C., & Longhurst, C. A. PubMed To ensure study rigor, manual coding was verified through triangulation of researchers, with adherence to trustworthiness criteria (10). PubMed The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). A randomized controlled trial. Confidentiality in Adolescent Health Care: ACOG Committee Opinion Lack of information in this area is a barrier to optimal health care and communication with the patient and the patient's family. When the health care provider is confronted with a situation in which he/she is part of a triangle between the parent and the adolescent and their individual values and beliefs are challenged by the situation, it is important to have a sound and solid knowledge of their jurisdictions legislative framework regarding confidential health care for adolescents and consent to treatment (15,16). Government of Canada. The nursing group consisted of both registered and licensed practical nurses; the physician group included both staff physicians and residents; the paramedical psychosocial support group included child life therapists, family support specialists, genetic counsellors, psychologists, social workers, spiritual care chaplains and psychosocial therapy aides; and the paramedical physical support group included dietitians, medical radiation technologists, occupational therapists, pharmacists, physiotherapists, psychometrists, respiratory therapists, speech language pathologists and physical therapy assistants. Practice settings should review and revise their clinical procedures (including spacing limits, scheduling, charting) to ensure that adolescents privacy and the confidentiality are fully protected. The SAHM and the AAP have both advocated for improved EHR technology to address these unique challenges [28] [29]. Obstet Gynecol 2020;135:e1717. Two provinces diverge from the mature minor doctrine at the present time. Abstract Confidential care for adolescents is important because it encourages access to care and increases discussions about sensitive topics and behaviors that may substantially affect their health and well-being. doi:10.1542/peds.2012-2580, peds.2012-2580 [pii]. (2005). However, another core concept in family-centred care is respect and dignity, which is upheld with adolescents when they have access to confidential health care (11). Institutional knowledge gaps included lack of evidence-based resources, and guidelines or policies regarding the practice of adolescent confidentiality. Confidentiality in Adolescent Health Care: ACOG Committee Opinion, Number 803. HCPs must be aware of, and conversant with, the federal and provincial/territorial legislation affecting health care privacy and confidentiality in their jurisdiction. 2020 Apr;135(4):e171-e177. Because knowledge gaps lead to practice gaps, adolescents rights to confidential health care may not be fully respected and medical histories may be inaccurate and incomplete, affecting assessment, interventions and outcomes. Chapel Hill, NC: Center for Adolescent Health and the Law. Silber, T. (1989). Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. Developing protocols to optimize confidential care in various settings can mitigate obstacles such as time constraints, space limits, and insurance practices that may compromise confidentiality. If the EHR system does not allow for procedures to maintain adolescent confidentiality, the obstetriciangynecologist or staff should inform the patient that parents or guardians will have access to the records, and the patient should be given the option of referral to a health care provider who is required to provide confidential care. Perspectives on confidential care for adolescent girls. This position statement has been reviewed by the Acute Care, Bioethics, and Community Paediatrics Committees of the Canadian Paediatric Society, as well as by the CPS Paediatric Emergency Medicine Section Executive and members of the College of Family Physicians of Canada. Other analyses of respondent comments revealed individual and team knowledge gaps regarding adolescent and parent/guardian rights, and the difference between the constructs of consent to treatment and the provision of confidential health care for adolescents. Nursing practice and statutory rape. HIV/AIDS surveillance report (Vol. Official action: Practice parameter for the assessment and treatment of youth in juvenile detention and correctional facilities. The survey consisted of 15 closed questions, six of which included a request for open comments. sharing sensitive information, make sure youre on a federal February). To investigate the knowledge and practice of health care providers at Alberta Childrens Hospital (Calgary, Alberta), and to inform practice about the adolescents right to confidentiality. This site needs JavaScript to work properly. J Prim Care Community Health 2012;3(2):99-103. Adolescent Health Care, Confidentiality | AAFP Adolescent, Confidentiality, Ethics, Privacy. Before Accessibility Les auteurs recommandent des stratgies pour amliorer la comprhension et les pratiques en matire de respect de la confidentialit chez les adolescents, soit encourager les individus examiner leurs croyances et favoriser les tudes postsecondaires, les stratgies de transfert du savoir au sein des programmes et les directives et politiques tablies par ltablissement. Family planning clinic clients: Their usual health care providers, insurance status, and implications for managed care. HCPs should advocate for EHR program development to block sensitive results from appearing on any patient portal. (2012). Pediatrics, 130, 11701174. Obstetrician-gynecologists and other health care providers and institutions that establish an electronic health record (EHR) system should consider systems with adolescent-specific modules that can be customized to accommodate the confidentiality needs related to minor adolescents and comply with the requirements of state and federal laws. Confidentiality for adolescents accessing health care is complex, and concerns about lack of confidentiality can be a barrier to receiving appropriate care 2 3. Adolescents with higher levels of risk behaviours, (i.e., substance use or mental health issues) are more likely to use an emergency department (ED) as their primary source of care [34]. There is widespread inconsistency among health care providers regarding understanding and practice of adolescent confidentiality. Whose personal control? Adolescent health services: Missing opportunities. J Adolesc Health 2020;67(2):164-71. Confidentiality in Adolescent Health Care: ACOG Committee Opinion official website and that any information you provide is encrypted Les invitations participer ont t expdies par la liste de courriels de ltablissement pdiatrique tous les dispensateurs de soins dtenant un poste et susceptibles de participer aux soins dadolescents. Federal government websites often end in .gov or .mil. The complex nature of the parent-child relationship in the context of a family-centred approach, along with the adolescents developing need for autonomy and continuing need for support, can pose significant ethical challenges for health care providers. Telemedicine can improve health care access and is likely to be an increasingly common option for medical interactions because it allows flexible scheduling. Strategies to facilitate the ability to provide confidential adolescent healthcare include explaining its importance to parents and adolescents, routinely spending part of each adolescent visit alone with the patient, discussing confidentiality, and addressing issues that increase risk of unintentional disclosure of protected information related to billing, Explanations of Benefits (EOBs), release of health records, and electronic health records. This was revealed in both the qualitative and quantitative data. Google Scholar. English, A., Ford, C. A., & Santelli, J. S. (2009). . This could include posted documents describing patient rights and making sure families and clinical staff are familiar with and respect these rules. The laws governing consent and confidentiality in adolescent health care vary from country to country . Homelessness, National Alliance to End Homelessness. Harrison C, Kenny NP, Sidarous M, Rowell M. Bioethics for clinicians: 9. If the EHR system does not allow for procedures to maintain adolescent confidentiality, the obstetrician-gynecologist or staff should inform the patient that parents or guardians will have access to the records, and the patient should be given the option of referral to a health care provider who is required to provide confidential care. Canada Health Act, RSC 1985, c C-6: https://canlii.ca/t/532qv (Accessed June 14, 2022).
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