uk healthcare patient portal governing laws about minors

When to grant patient portal access solely to minors?

Under HIPAA 45 CFR 164.502, this sometimes prevents UK HealthCare from releasing information to the parent/guardian. For patients between the ages of 0 (birth) and 11 years 364 days, proxy account holders can use the UK HealthCare MyChart portal to: Send a secure email message to the child’s care team. Request prescription renewals 24 hours a day.

What are a parent's rights to a minor's health information?

Nov 29, 2016 · An Overview of Minors' Consent Law from the Guttmacher Institute The legal ability of minors to consent to a range of sensitive health care services—including sexual and reproductive health care, mental health services and alcohol and drug abuse treatment—has expanded dramatically over the past 30 years. This trend reflects the recognition that, while …

Do minors have the right to consent to health care services?

Key legislation. The Health and Social Care Act 2012 introduced the first legal duties about health inequalities. It included specific duties for health bodies including the Department of Health, Public Health England, Clinical Commissioning Groups, and NHS England which require the bodies to have due regard to reducing health inequalities ...

Should minors be allowed to view their health records online?

The AMA Code of Medical Ethics Opinion 2.2.1 discusses the responsibility physicians have to engage minor patients in the decision-making process at a …

What information is excluded from a patient portal?

What are healthcare policies in the UK?

Is follow my health the same as MyChart?

Does University of Kentucky hospital use Epic?

What is clinical governance UK?

What are legislations in health and social care?

How do I add my child to FollowMyHealth?

What is FollowMyHealth portal?

What is a FollowMyHealth account?

What is EpicCare link?

What EMR does University of Kentucky use?

Can a parent access a minor's medical records?

Healthcare providers can choose to give parents access to the minor's records via a patient portal, but the providers should consider segregating certain information to make those confidential services inaccessible by the parent, Greene says.

What is meaningful use stage 2?

In particular, meaningful use Stage 2 is pushing for healthcare providers to provide more immediate access, particularly the ability to view, download, and transmit information through what is normally expected to be some sort of patient portal.

What is the Health and Social Care Act?

The Health and Social Care Act 2012 introduced the first legal duties about health inequalities. It included specific duties for health bodies including the Department of Health, Public Health England, Clinical Commissioning Groups, and NHS England which require the bodies to have due regard to reducing health inequalities between the people ...

What is the Equality Act 2010?

The Equality Act 2010 established equality duties for all public sector bodies which aim to integrate consideration of the advancement of equality into the day-to-day business of all bodies subject to the duty.

Can minors consent to mental health services?

Additionally, some state laws permit unemancipated minors to consent to receive certain types of services on their own, such as reproductive, substance abuse, or mental health services. The Guttmacher Institute provides a summary of minors' consent laws by state.

Do foster children need consent?

Children in foster care require special consent and privacy considerations. Although this area is highly dictated by state law, generally the state's department of social services can consent to health care for a child in the foster system.

Is HIPAA a confidentiality law?

HIPAA's confidentiality rules are challenging enough to apply in a typical patient scenario, with an adult patient making his or her own health care decisions. When third parties such as parents of adolescent patients are involved, privacy considerations become even more complex. Physicians must consider not only federal and state laws ...

Which states have HIPAA protections?

A handful of states, including California, Colorado, Washington, Oregon, and Maryland, have taken steps to strengthen HIPAA's health insurance confidentiality protections such as requiring insurers to honor patients' confidentiality requests, particularly if they involve sensitive services.

Consent laws and portal policies

Under most state and federal laws, for a minor to obtain health care services, the minor's parent or legal guardian must consent to such services. However, under certain circumstances, state laws and HIPAA permit minors to consent to care on their own.

Results

Since implementation, 1,534 adolescent patients have activated a portal account. Not counting patients who have since transitioned to adult accounts or otherwise left the system, the Institute currently has more than 500 adolescent users. Of these users, 223 have logged in more than five times in the past 12 months.

What is a patient portal?

Patient portals are web- and mobile-based programs that allow patients and their proxies remotely to interact with healthcare systems and their care providers. 1–3 These portals commonly allow users to view selected information from the electronic health record (EHR), review test results, message providers, schedule appointments, and pay medical bills. 4 A report by the Institute of Medicine specifies online access to personal health records, such as patient portals, as a promising technology to support patient engagement. 5 Functionality delivered through patient portals has been shown to improve chronic disease management, increase adherence to preventive care such as immunizations and screening, improve patient satisfaction, and better outcomes for some patients with chronic disease. 6–14

What is a well designed patient portal?

Well-designed patient portals, when combined with policies that promote use, offer significant opportunity for patients to engage in their healthcare. Without proper management, portals can suffer from decreased use and poor support from providers. In this work, we discuss the patient portal policies that govern account registration and management, shared access, and test result reporting at VUMC. We anticipate that other organizations can implement concepts from our policies to support the meaningful use of patient portals.

What is MHAV in Vanderbilt?

My Health at Vanderbilt (MHAV) is an institutionally developed patient portal which launched in a limited fashion in 2003 before being more widely deployed throughout all clinical specialties starting in 2007 ( Figure 1 ). The VUMC informatics, legal and operational teams internally established policies and procedures to govern MHAV use by patients, proxies, and healthcare providers. The initial policies are described by Osborn et al. 29 MHAV and its associated EHR were certified for Meaningful Use stages 1 and 2. MHAV supports core functionality similar to those of other patient portals, including secure messaging, appointment scheduling, bill management, access to select laboratory results, and access to select EHR data. 29,32 There were incremental changes to usage logging and functionality throughout the duration of continuous use.

What is proxy access?

Proxy access is defined as an access class in which one individual receives access to another individual’s protected health information, communication tools, and functions in MHAV. In all cases, the proxy had to meet the eligibility criteria outlined in the table, even if the patient did not. Individuals could serve as proxies for competent adult patients, patients who were children or adolescents, and adult patients who met legal criteria for lacking the capacity to make medical decisions. VUMC policy distinguished two general categories of proxies: delegates and surrogates. The policy defined delegates as “an adult individual invited by a MHAV account holder to have access to that account holder’s MHAV account,” and stipulated that the account holder be a competent adult. For example, a competent adult may invite her spouse, adult friend, and adult child aged 18 or older to have delegate access to her account.

Do minors have rights to health care?

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 (STI) 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. Obstetrician–gynecologists 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 obstetrician–gynecologist may still provide counseling about contraceptive options. It is important for obstetrician–gynecologists to be aware of their individual state and local laws.

What is a mature minor?

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 minor’s 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.*

What is confidentiality in medical terms?

Confidentiality refers to protection of privileged and private information shared during a health care encounter and in medical records that document the encounter 1. Confidentiality for adolescents accessing health care is complex, and concerns about lack of confidentiality can be a barrier to receiving appropriate care 2 3. ...

Why is confidential care important for adolescents?

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.

What is patient portal?

Patient portals are mechanisms within the EHR system that provide patients with electronic access to their personal health record. Patient access varies widely across institutions and by the type of EHR used by the health care provider. Most EHRs have the capability for patients to view any combination of appointments, medication lists, allergies, most recent vital signs, laboratory values, health care provider notes, and communication between patient and health care provider. A 2016 study demonstrated that, when given the opportunity, adolescents’ use of EHRs afforded enhanced medical care and, although they accessed the portal less for laboratory results, appointments, or prescriptions, adolescents did engage in frequent confidential communications with their health care providers through patient portals 4. Many institutions struggle to meet the current standard for providing access to and maintaining the confidentiality of sensitive portions of the medical record as required by the Centers for Medicare and Medicaid Services 4. Most EHRs were not designed to provide item-specific control over parental or guardian access and release of adolescent health care information. Additionally, it is costly for vendors to develop and maintain the levels of mandated confidentiality because the laws regarding confidentiality vary by state 4.

What is an explanation of benefits statement?

Explanation of benefits statements (health care billing and insurance claims sent by insurance carriers) are an additional challenge to confidentiality. Adolescents should be aware that certain insurance carriers itemize explanation of benefits statements 7. Potential for disclosure of laboratory results, prescriptions, and diagnoses may occur with itemized explanation of benefits statements. Being aware of alternate health care referral centers for free or substantially decreased costs may be of benefit for the adolescent if there is a risk of billing disclosure. Obstetrician–gynecologists should work with their health care organizations to be able to provide confidential billing. In certain instances, specific billing modifiers used with preventative services provided under the Patient Protection and Affordable Care Act will generate nonitemized explanation of benefits statements.

The Role of Patient Portals

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Privacy Challenges with Patient Portals

Authentication For Portal Use

Why only Passwords?

Minors' EHRs

Adult Caregivers

Other Methods of Access

Biggest Emerging Threats