How to safeguard the PHI of minors

Minor patients' protected health information (PHI) must be safeguarded like adult patients' medical information, but there are additional concerns. This protection comes with requirements that all healthcare providers need to consider when implementing policies and procedures. 

Challenges in safeguarding the privacy of minor PHI

Obtaining informed consent and parental authorization for minor patients adds complexity when dealing with a minor's PHI. In cases where the guardianship of the patient is not clear, providers must have measures to ensure that consent is viable and from the minor's proper representative. There may also be instances where minors seek confidential healthcare services, such as reproductive health or mental health, where disclosing information to parents may not be in the minor's best interest or legally required. 

Sharing minor PHI among healthcare providers, especially in multi-disciplinary or multi-institutional settings, requires coordination and strict adherence to privacy regulations. Ensuring seamless communication while protecting the privacy of the minor's information poses challenges, particularly when involving electronic health records (EHRs) or health information exchanges (HIEs).

Related: Legislation that applies to minor patient data

Best practices for handling minor patient data

1. Develop comprehensive privacy policies: Establish clear and comprehensive privacy policies that address the specific requirements of protecting minor patient data. These policies should outline procedures for obtaining consent, data access controls, data sharing protocols, data retention, disposal practices, and breach response plans.
2. Secure data storage and transmission: Use encryption techniques to secure data both at rest and in transit. Ensure that electronic health records (EHRs) and other data storage systems are secure and utilize secure channels when transmitting data. Regularly assess and update security measures to align with industry standards.
3. Monitor and audit data access: Regularly monitor and audit data access logs to detect unauthorized access or breaches. Conduct periodic internal audits to assess compliance with privacy policies, identify vulnerabilities, and implement necessary improvements.
4. Conduct privacy impact assessments: Perform privacy impact assessments to identify and mitigate privacy risks associated with the collection, use, and disclosure of minor patient data. These assessments help identify potential gaps in privacy practices and ensure compliance with relevant legislation.
5. Establish data sharing agreements: When sharing minor patient data with other healthcare entities, research organizations, or educational institutions, establish data sharing agreements that outline the purpose, scope, and security measures for data sharing. Ensure compliance with applicable legislation and protect the privacy of the data.

Related: How to train healthcare staff on HIPAA compliance

Ensuring compliance with legislation and regulations 

Compliance with Children's Online Privacy Protection Act (COPPA)

1. Obtain parental consent: Healthcare providers operating websites, online services, or mobile apps that collect personal information from minors under the age of 13 must obtain verifiable parental consent before collecting, using, or disclosing such information. Implement mechanisms to obtain and document parental consent in a reliable manner.
2. Provide notice to parents: Clearly inform parents about the types of information collected from minors, how it will be used, and any third parties with whom it may be shared. Maintain a comprehensive and easily accessible privacy policy that explains these practices.
3. Securely handle data: Implement appropriate security measures to protect the personal information of minors. This includes encryption, access controls, and regular security assessments to ensure the integrity and confidentiality of the data.
4. Retention and deletion: Establish policies for the retention and deletion of personal information collected from minors. Retain data only for as long as necessary and securely dispose of it when it is no longer needed.

Compliance with Family Educational Rights and Privacy Act (FERPA)

1. Obtain consent from eligible students or parents: Obtain written permission from eligible students (typically 18 years or older) or their parents, depending on the student's age and legal rights, before disclosing education records, including health-related information. Adhere to FERPA's requirements for consent and keep a record of the consent obtained.
2. Safeguard education records: Implement appropriate security measures to protect the privacy and security of education records, including any health information. Use secure storage, access controls, and staff training to prevent unauthorized access, use, or disclosure of the records.
3. Data sharing agreements: When disclosing education records, establish data sharing agreements with educational institutions or authorized entities that receive the records. These agreements should outline the purpose of the disclosure, the security measures in place, and the receiving party's responsibilities in protecting the data.

Compliance with State-specific Laws

1. Stay informed: Keep abreast of state-specific laws and regulations that govern the protection of minor patient data in the jurisdictions where the healthcare provider operates. Regularly review and update privacy policies, procedures, and practices to align with any changes in state laws.
2. Customize practices: Tailor privacy practices and procedures to comply with specific state requirements. This may include obtaining additional parental consent, implementing particular security measures, or addressing special provisions in state laws related to minors' healthcare information.

Related: HIPAA Compliant Email: The Definitive Guide