Sensitive Health Care Services in the Era of Electronic Health Records

Sensitive Health Care Services in the Era of Electronic Health 
Records: Challenges and Opportunities in Protecting Confidentiality for Adolescents and Young Adults

Authors: Sara Daniel, MPH, Jan Malvin, PhD, Carolyn B. Jasik, MD, Claire D. Brindis, DrPH

Access to confidential care is critical for adolescents and young adults, particularly those seeking sensitive services, including sexual and reproductive health, mental health and substance abuse services. Implementation of the Affordable Care Act (ACA) brings new opportunities and challenges for adolescents and young adults. ACA has the potential to improve access to sensitive services by increasing the number of young people with insurance coverage and also by increasing access to certain preventive services without cost sharing. Along with the ACA, the implementation of the Health Information Technology for Economic and Clinical Health Act (HITECH) has stimulated the increased use of electronic health records (EHR). Although EHR products are expected to improve care coordination, most do not allow control over health information details, which could compromise confidentiality. Similarly, open sharing and release of records through health information exchanges may give the patient the impression that their sensitive information is not secure. The purpose of this brief is to summarize key issues affecting access to sensitive services for young Californians, including current federal and state confidentiality laws, and data privacy challenges and opportunities related to EHR implementation and use.

This study was conducted by: The Philip R. Lee Institute for Health Policy Studies and the Division of Adolescent Medicine, Department of Pediatrics, at the University of California San Francisco.

The report can be found at: