Confidentiality in Adolescent Health Care

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. Obstetrician-gynecologists and other health care providers who care for minors should be aware of federal and state laws that affect confidentiality. There should be private conversation time between the health care provider and adolescent patient. Generally, parents or guardians and adolescents should be informed, both separately and together, that the information each of them shares with the health care provider will be treated as confidential. Additionally, they should be informed of any restrictions to the confidential nature of the relationship. 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. 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. Obstetrician-gynecologists are encouraged to know their individual systems and institutional policies regarding confidentiality, EHRs, patient portals, and the open access for visit notes. This document has been updated to include information on patient portals, guidance on the release of medical records, examples of ways to safeguard adolescent patients' confidentiality, and talking points to use with parents and guardians.