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Why Is Conversation Time Alone So Important

It provides a safe space to ask questions: Talking to adolescents one-on-one also gives adolescents a chance to ask questions or give information they may feel self-conscious about. Adolescents often have questions or concerns that they may feel embarrassed to talk about in front of their parents or guardians.

  • It builds trust: Experimenting with a range of behavior is common among adolescents and young adults. Often, the behavior is not disclosed to parents or guardians. While gaining the adolescents trust, we still encourage them to discuss issues with their parents or guardians.

  • Release Of Medical Records

    In order to ensure the privacy of the adolescent is not violated under HIPAA, obstetriciangynecologists and other health care providers should educate their patients about what information is released when a request or release of records is sent to a health care provider, including if a parent or guardian requests a release of information or a patient requests a release to the parent or guardian. An example of how to address this request: the health care provider can review the record to ensure there is no violation of confidentiality and then contact the patient directly to make sure that the patient approves of the information contained before its release. Any concern for a HIPAA violation should be addressed by individual health care systems. Similar caution should be assumed when releasing information to other health care providers. Obstetriciangynecologists should be aware of how the process of the release of medical records of minors is addressed by their institution.

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    Select your current Job Position: Is this your first time taking the HIPAA and Privacy Act Training Course? – answer Patient Services No, but I need annual trainingIn which of the following circumstances must an individual be given the opportunity to agree or object to the …

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    Talking Points For Discussing Confidentiality With Parents And Guardians

    As your adolescents doctor and as the parent , we have two roles here. First, we want to make sure that adolescent patients have access to health care to make sure that they are healthy and safe. Second, we want to make sure that they have had the opportunity to learn to talk with a doctor by themselves so that when they are young adults, they are prepared to communicate and advocate for what they need.

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    Suggestions For Protecting Adolescent Confidentiality Within Institutions

    Obstetriciangynecologists are encouraged to know their individual systems and institutional policies regarding confidentiality, EHRs, patient portals, and the open access for visit notes. The following are examples of how some institutions have provided protection to adolescents they are not applicable to all institutions or systems:

    For patients ages 1217-years old, manage or restrict parental or guardian access to provider notes.

  • Require a parent or guardian code word to access an adolescents patient portal.

  • Allow parental or guardian access to the EHR to expire at the age state law requires confidentiality. When a patient turns 18 years old, allow EHR systems to reset the patient as an adult. This will allow patients to create their own direct access to their record, rather than through a parent or guardian.

  • For patients ages 18 and older, require a signed release of information for a parent or guardian to ask health questions about the adolescent by telephone.

  • Review individual cases and provide proxy access for parents of adolescent patients with disabilities when appropriate.

  • House confidential information in a separate section of the EHR that is not open access.

  • Flag a portion of the visit note as confidential in order for those sections to be omitted from access by a parent or guardian.

  • Add sensitive information into the prose of the visit note that is not included in billing or hospital searchable data.

  • Box 3.

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    Addressing Patients And Parents Or Guardians About Confidentiality

    Although confidentiality routinely is practiced in adult medical care, this standard may be perceived differently by a parent or guardian when it involves the health care concerns of the adolescent. At the initial visit, the obstetriciangynecologist should discuss the following issues with the parent or guardian and the patient: 1) the meaning and importance of confidentiality 2) the scope of confidentiality protection and 3) the limitations of confidentiality 1. See Box 1 and ACOG Committee Opinion No. 758, Promoting Healthy Relationships in Adolescents, for potential talking points when discussing confidentiality with parents, guardians, and patients 10.

    Box 1.

    Legal Principles And Definitions Of Adolescents Rights To Receive Health Care Independently

    HIPAA Compliance Checklist

    Mature minor: An adolescent younger than the age of majority who, even if living at home as a dependent, demonstrates the cognitive maturity to give informed consent. The capacity of an adolescent to consent for health care as a mature minor is influenced by the minors developmental maturity, previous experience with illness, the gravity of the current illness, and the risks of proposed therapy. The right of a mature minor to consent to medical care without previous parental or guardian consent has been recognized in many states.*

    Emancipation: A legal procedure whereby minors become legally responsible for themselves, and their parents or guardians are no longer responsible . The minor can consent to medical, dental, or psychiatric care. Statutes vary by state, but minors may become emancipated when they marry, serve in active duty in the U.S. military, or obtain a declaration from the court.

    *For more information, see Guttmacher Institute. An overview of consent to reproductive health services by young people. New York, NY: Guttmacher Institute 2019. Available at: . Retrieved November 15, 2019.

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    Why Is Confidentiality Vital

    Adolescents gain more ownership over their own health: We encourage adolescents to be active participants in their health care as a step toward becoming adults and to take on more responsibility. As part of comprehensive health care, it is our practice to ask parents to wait outside for part of the interview and to encourage the adolescents to discuss their own interests and concerns.

    Provision Of Health Care To Adolescent Patients

    Although laws vary by state, all minors have a right to some confidential health care. All states and the District of Columbia allow minors to consent to sexually transmitted infection testing and treatment without parental permission 14. Other states have consent laws that include substance misuse treatment, pregnancy prevention and care, and, sometimes, abortion services, mental health care, and emergency care. Adolescents also have rights to receive health care independently under legal principles such as mature minor and emancipated minor Box 2. Obstetriciangynecologists should not misinterpret consent required to provide health care services with consent required to provide education and counseling that is, even when consent is required by a parent or guardian for provision of contraception, an obstetriciangynecologist may still provide counseling about contraceptive options. It is important for obstetriciangynecologists to be aware of their individual state and local laws.

    Box 2.

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