Policy Priority Issue

Chamberlain College of Nursing

NR 506 Healthcare Policy

November 12, 2017

Policy Priority Issue

The healthcare priority issue which was chosen was the dilemma which ensues when handling adolescent personal healthcare records. Though the current HIPAA ensures a certain level of security of the adolescents’ health record it does not guarantee a comprehensive protection. This is because the parents still have a proxy access to the electronic health records of their children. This makes the adolescents mistrust the healthcare system and have the fear that their confidential health information might be disclosed to their parents. This is more prevalent when the adolescents are suffering from STIs or when they intend to seek intervention over their reproductive health.

There is no doubt that the Electronic Health Record (EHR) system has been instrumental in the transformation of the healthcare system in the US. However, on the side of the adolescents, it has not been a complete advantage but has come laden with its own disadvantages. While the HIPAA provides a comprehensive protection for adult patient healthcare data, it does not do so for the minors but gives the parents a certain level of access to the minors’ health records. Such proxy access by parents of their children’s data is unfavorable especially for adolescents whose self-awareness is high. A consensus on this matter should be reached and a balance established, otherwise the adolescents will continue to suffer and fail to disclose their healthcare needs to healthcare givers for fear that their parents will at some point get hold of this sensitive information. The best approach on this matter is to give the adolescents the full control over who can or cannot access their medical records.

Background of the Policy Priority

In the United States, the law dictates that individuals have a right to privacy and that personally identifiable information should not, without the permission of the person concerned, be disclosed to the public. This law is also similar to most industrialized countries. The law is even stricter when it comes to the health information of individuals. Any health information about the patients is handled with the highest levels of confidence. The disclosure of such information occurs only in the event that the patient or his/her representative gives the consent for such an action. The complexity of health records has of late been simplified by the use of the electronic health record system and the online portal where patients can log in and view information about their past health history. The health areas which have over time been identified as most sensitive include, information about mental health, reproductive health, physical abuse, and areas which have a linked social effect such as drug abuse.

The Health Insurance Portability and Accountability Act HIPAA of 1996 captures most of the frameworks and policies enforced to protect the confidentiality of the patients’ data. It thus has the procedures and the limits which should not be exceeded in the retrieval of the patients’ data. The protection of the patient information covers all the avenues; verbal, electronic and paper formats. All the patient information is protected unless this protection is lifted in case such an action is required by the law. This protection of patient data only applies to adults and becomes complex when the minors are involved. This is because of the conflict of interest between the parents/guardians and the minor (Glenn & Monteith, 2014).

Empirical Evidence

Nurses and other healthcare givers are bound by the principle of confidentiality and at the same time by the duty to disclose information especially when such disclosure may be beneficial to the patient. Whether to disclose or hold in confidentiality the health records of the adolescents raises different viewpoints. The dilemma is aggravated by the fact that HIPAA policies on adolescents’ health record disclosure usually collide with other policies which dictate that the parents have a right to the knowledge of their children’s health status. Disclosure of health information to parents negatively impacts on the willingness of the adolescents to seek medical care when they are faced by sensitive health issues such as drugs, STIs and reproductive healthcare. Non-disclosure, on the other hand, may imply that the parents and the minor’s representatives do not have enough information to help them deliver the necessary support for the recovery/adjustment of their children (Hiriscau, Stingelin-Giles, Stadler, Schmeck & Reiter-Theil, 2014).

The developmental stage of adolescents make them interested in all sorts of information. One area of great quest for information is about their sexuality. To get this highly needed information, adolescents employ different methods. One of these is to use the same-sex peers to furnish them with answers to their unanswered questions. Rarely do they approach the parents especially when the parents are not receptive on these topics. Healthcare facilities are best fitted in providing this information alongside guidance and counseling. However, the fear that the concerns of these adolescents will be disclosed to their parents makes them reluctant in seeking this vital information. The end result is that this group of minors end up acquiring distorted information from unsolicited and uncensored sources and may end up using it to the detriment of their health. The best intervention would, therefore, be to come up with a policy which guarantees maximum protection of the adolescent’s health information (Baheiraei, Khoori, Foroushani, Ahadi & Ybarra, 2014).

A solution to the existing dilemma can be solved when the issue is approached from the adolescent perspective. Proper policy to elucidate this impeding priority issue is to identify the different elements within the dilemma. Different stakeholders should be involved in the crafting of a suitable policy and the responsibility shared among different professionals and quarters. Both the adolescents and the healthcare givers should be asked questions which will shed more light on the issue. The objective data obtained from these studies will then be used in the shaping of a balanced policy (Spooner, 2016).

Importance and the Impact

An integrated policy on the adolescents’ right to control who accesses their health records will have several benefits. First, it will benefit the nurses and other healthcare practitioners as they will have a clear laid down procedure and standard to follow whenever they are handling adolescents’ data. The risk of unintentional confidentiality breach by health practitioners which can lead to legal tussles will also be reduced. The adolescents will have increased confidence over the healthcare system. More adolescents will, therefore, seek medical interventions. The adolescent’s experience with the healthcare services will also improve greatly. The mortality rate among the adolescents which is associated with drug abuse, unsafe abortion procedures, and STIs exacerbation will be effectively curbed when this policy is put into place (Boman, Bohlin, Eklöf, Forsander, Munthe, & Törner, 2017).


There are laws and policies which protect the patient health records. Though this is true, the issue of minors become complex because of the conflicting interest between those of the parents and the minor. When such a minor is an adolescent a threat of disclosure of health information may deter many adolescents from seeking medical care even when faced with critical health conditions. To curb this fear among the adolescents more control in determining who can view their health records should be accorded. This will increase their confidence in the healthcare system and thus see many turn out to seek medical interventions.


Baheiraei, A., Khoori, E., Foroushani, A. R., Ahmadi, F., & Ybarra, M. L. (2014). What sources do adolescents turn to for information about their health concerns? International journal of adolescent medicine and health, 26(1), 61-68.

Boman, Å., Bohlin, M., Eklöf, M., Forsander, G., Munthe, C., & Törner, M. (2017). Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background. SAGE Open Medicine, 5, 2050312117700056.

Glenn, T., & Monteith, S. (2014). Privacy in the digital world: medical and health data outside of HIPAA protections. Current psychiatry reports, 16(11), 494.

Hiriscau, I. E., Stingelin-Giles, N., Stadler, C., Schmeck, K., & Reiter-Theil, S. (2014). A right to confidentiality or a duty to disclose? Ethical guidance for conducting prevention research with children and adolescents. European child & adolescent psychiatry, 23(6), 409-416.

Spooner, S. A. (2016). Protecting Privacy in the Child Health HER. In Pediatric Biomedical Informatics (pp. 27-36). Springer Singapore.