Parents can now see medical records of Alberta teens, raising concerns among doctors

Some Alberta doctors are warning a move by the provincial government to expand parental access to teenagers’ medical records could put some patients at risk.

Until this week, parents and guardians could only access personal health information of children under 12 online.

The Alberta government has now extended that access until teens turn 18.

Change came into effect on Monday.

“Parents and guardians play a vital role in supporting their children’s health, and access to health information helps them make informed decisions, get needed care and ensure continuity of care,” a government spokesperson said in a statement emailed to CBC News.

This change applies to Alberta MyHealth Records The portal, which provides access to information such as laboratory results, prescriptions, clinical reports, vaccination records and appointment summaries.

“I’m concerned because I think this will put some teenagers’ health care at risk,” said Dr. Sam Wong, chair of the pediatric section of the Alberta Medical Association.

He has been flooded with emails from doctors across the province who were shocked by the move.

“Colleagues have sought me out to discuss this issue,” he said. “That’s a big concern of theirs – a big concern,” he said.

According to Wong, this change may deter some teens from seeking care about sensitive issues such as contraception.

“If they don’t get the medication, does that create a risk of pregnancy? And that’s a distinct possibility,” he said.

The Canadian Pediatric Society has also weighed in, arguing thatConfidentiality is essential to providing quality adolescent health care.

“By ensuring appropriate personal care, physicians can empower adolescents to develop agency, autonomy, confidence, and responsibility for making and managing their own health care decisions,” a spokesperson said in an emailed statement.

“Concerns about privacy can be a significant barrier for adolescents, who may delay or decline needed treatment or follow-up care if they are not assured of privacy.”

According to the Society’s 2023 position statement, adolescents are less likely to disclose information about substance use, mental health and sexuality when confidentiality cannot be guaranteed.

The document also states that not all adolescents receive parental support and, in some cases, disclosure of sensitive information may put adolescents at risk of abuse, maltreatment or exclusion.

long term effects

“If they’re not able to access that care because they’re afraid to disclose information (or) obviously that can result in really adverse health outcomes,” said Dr. Stephen Freedman, professor of emergency medicine and pediatrics at the University of Calgary’s Cumming School of Medicine.

Friedman said it’s common for teens in emergency rooms to talk alone, away from a caregiver, in sensitive situations.

This may include a scenario where a teenage girl is experiencing stomach pain and is not comfortable discussing sexual activity in front of parents.

“It’s a confidential relationship and we don’t think that should be violated,” he said.

“It really compromises the care that we can provide to adolescents if we can’t have those conversations and test them with confidence that we’ll be able to make sure that confidentiality is maintained after seeing them.”

And the implications could be long-term, he said.

For example, untreated sexually transmitted infections can increase the risk of pelvic inflammatory disease and affect one’s ability to have children, she said.

Friedman is also concerned that caregivers will see information about tests or prescriptions that occurred before the change and were done with an understanding of confidentiality.

This can reduce trust between the teen and the health care provider, as well as between the teen and his or her caregiver, he said.

Province confirmed Parents will be able to view certain historical information related to lab results, prescriptions and visits to facilities that are part of the province’s Connect Care system.

Under the new rules, 16- and 17-year-olds can request through a health care provider that parental access be revoked.

‘Misalignment’

in Canada, mature short theoryAccording to health law expert Lorien Hardcastle, part of the common law recognizes adolescents’ capacity to make decisions.

“There is a presumption in most provinces that minors can consent to treatment without parental involvement,” said Hardcastle, an associate professor in the Faculty of Law and Cumming School of Medicine at the University of Calgary.

“This change creates a misalignment between your ability to receive treatment without your parent’s involvement, yet now your parent will potentially be able to see records of that treatment.”

Hardcastle says the availability and rollout of online medical records varies widely across the country, making provincial comparisons regarding parent access difficult.

For example, in British Columbia, parental access ends at age 12, according to the provincial government website. Information about dependents is currently limited to their vaccination history.

In Saskatchewan, the cut-off age is 14. A spokesperson said parents and legal guardians can request access to the health information of children under 14. Teens ages 14 and older who create their own online health records account can choose whether to share access with their parents.

“This approach, introduced in 2021, balances the role of a parent or guardian with a minor’s legal right to privacy, which is critical to ensuring youth feel safe accessing health care, including sensitive health services,” a statement from an eHealth Saskatchewan spokesperson said.

In Prince Edward Island, which is in the early stages of its electronic medical record rollout, residents must be 16 or older to access some parts of their personal health information. The province said parental access is planned for future phases.

The 2023 Canadian Pediatric Society position statement states that online records are still developing, and most are not designed to provide item-specific parental access controls.

“The optimal solution would be to develop a separate portal for juveniles when they are considered mature minors, but such transitional technologies are not readily available,” it said.

In a written statement, the Alberta government acknowledged the rights of mature minors, but noted there is no universal approach in terms of how the province handles access to personal health information.

“Protecting patient confidentiality and respecting the rights of mature minors are legislative requirements,” said Madison McKee, press secretary to Alberta’s Minister of Primary and Preventive Health Services.

“Safeguards are in place that allow health care providers to limit or remove parental access to a child’s online health information where appropriate, including to minimize the impact on youth seeking sensitive or essential health services.”

The province said it has submitted a privacy impact assessment to the Office of the Information and Privacy Commissioner of Alberta. A spokesperson for that office confirmed to CBC News that it is reviewing the submission and discussing it with the government.