Confidentiality in adolescent health care

Abstract

Adolescents should have access to developmentally appropriate high quality confidential health care within professional, ethical, and legal guidelines. Clinicians and health care systems who provide this care have a higher likelihood of being able to effectively address the types of sensitive health issues linked to major causes of morbidity and mortality in this age group. These include health issues related to sexual behaviors, substance use, and mental health. Strategies to facilitate the ability to provide confidential adolescent healthcare include explaining its importance to parents and adolescents, routinely spending part of each adolescent visit alone with the patient, discussing confidentiality, and addressing issues that increase risk of unintentional disclosure of protected information related to billing, Explanations of Benefits (EOBs), release of health records, and electronic health records. Clinicians need to become familiar with federal and state laws that influence practice and policies in their specific setting, and how to provide health care within this context to adolescent patients during routine and acute care. Special expertise is needed by clinicians providing health care to adolescents and young adults who are living in foster care, in juvenile justice settings, with or at risk for HIV/AIDS, in families associated with the US Armed Forces or who are themselves active military, and youth who are homeless.