Preserving privacy for pediatric patients and families: use of confidential note types in pediatric ambulatory care. Confidentiality in health care: a survey of knowledge, perceptions, and attitudes among high school students. doi:10.1093/jamia/ocy042Ĭheng TL, Savageau JA, Sattler AL, DeWitt TG. Variability in adolescent portal privacy features: how the unique privacy needs of the adolescent patient create a complex decision-making process. Meaningful use of a confidential adolescent patient portal. Thompson LA, Martinko T, Budd P, Mercado R, Schentrup AM. These findings have implications for health systems intending to rely on separate adolescent accounts to protect adolescent confidentiality. In this study, more than half of adolescent accounts with outbound messages were estimated to have been accessed by guardians at least once.
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After correcting for the sensitivity and specificity of the algorithm based on manual review of 200 accounts per institution, an estimated 64% (95% CI, 59%-69%) to 76% (95% CI, 73%-88%) of accounts with outbound messages were accessed by guardians across the 3 institutions. The percentage of adolescent portal accounts with apparent guardian access ranged from 52% to 57% across the 3 institutions. A total of 1797 adolescents (52%) were female and mean (SD) age was 15.6 (1.6) years. Percentage of adolescent portal accounts indicating guardian access.Ī total of 3429 eligible adolescent accounts containing 25 642 messages across 3 institutions were analyzed. The overall proportion of accounts with guardian access was estimated after correcting for the sensitivity and specificity of the natural language processing algorithm. The sensitivity and specificity of the algorithm at each institution was estimated through manual review of a stratified subsample of patient accounts. A rule-based natural language processing algorithm was used to analyze all portal messages from June 1, 2014, to February 28, 2020, and identify any message sent by guardians. Adolescent patients (aged 13-18 years) with access to their patient portal account with at least 1 outbound message from their portal during the study period were included. To estimate the prevalence of guardian access to adolescent patient portals at 3 academic children's hospitals.Ī cross-sectional study to estimate the prevalence of guardian access to adolescent patient portal accounts was conducted at 3 academic children's hospitals. Guardian access of adolescent patient portal accounts could compromise adolescents' confidentiality. Patient portals can be configured to allow confidential communication for adolescents' sensitive health care information. 14 Department of Medicine, Stanford University School of Medicine, Palo Alto, California.13 Center for Biomedical Informatics Research, Stanford University, Palo Alto, California.12 Department of Pediatrics, University of California San Diego, La Jolla.11 Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.10 Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus.9 Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, Ohio.8 Department of Pediatrics, The Ohio State University College of Medicine, Columbus.7 Department of Biomedical Informatics, Stanford University School of Medicine, Palo Alto, California.6 Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, California.5 Information Management Division, Rady Children's Hospital, San Diego, California.4 Department of Hospital Medicine, The Ohio State University College of Medicine, Columbus.3 Division of Clinical Informatics, Nationwide Children's Hospital, Columbus, Ohio.2 Information Services, Stanford Children's Health, Palo Alto, California.1 Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
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