Wednesday, August 24, 2005
That's the title of an article in today's Wall Street Journal (link good for 7 days). Here's the essence of the piece:
Using her health plan's Web site, Ursula Scott of Seattle can view the medical records of her 2- and 5-year-old daughters, check their immunization schedules, look up test results, exchange email with a pediatrician, and make appointments for the next office visit.
But when it comes to her 16-year-old stepson, no one in the family can gain access to any aspect of his electronic medical records -- including the teen himself.
In the long-running effort to balance the rights of parents and adolescents in making decisions about medical care, technology has opened up a thicket of new legal and technical issues. The result is that teens are being left out of one of the most important advances in the administration of health care today.
A growing number of health plans, hospitals and doctor's offices are making the switch to electronic medical-record systems, in response to the Bush administration's push to make online records available to all Americans within the next decade. Such systems, like the one run by Group Health Cooperative of Seattle, which covers the Scott family, offer more than just convenience. They hold the promise of faster sharing of vital medical information, reduction of medical errors and more control for consumers over their care.
But with teens, these efforts risk running afoul of a complex patchwork of federal and state laws that allow adolescents to seek confidential family-planning and mental-health services without their parents' consent. Such laws make certain aspects of teens' health records off-limits to parents. However, electronic medical-records systems don't yet have a foolproof way to flag confidential material and hide it from parents -- something that can more easily be done with paper records. And as minors, teens can't on their own enter into the security agreements required to grant access to their online records.
Until providers can figure out how to give parents access to basic health-care information for a child, without breaking confidentiality or access rules, many are leaving adolescents out of new electronic medical-records systems altogether -- and revoking parental access to children's records as soon as they turn 13.
In a sentence, "At Dallas Children's Hospital, Chief Medical Information Officer Joseph Schneider, sums up the issue: 'Teens enter into this limbo land, where we can hide information from their parents, but we can't necessarily share it with them.'"
The article has a lot of useful material, including these links for more detailed information about adolescents' access to sensitive health care information:
(click on image to enlarge)