Confidentiality Tips

Confidentiality Concerns:

• Speaking with the youth alone in a confidential manner is ideal. Start with, “The things we talk about can be kept confidential, meaning I don’t have to share with your parent/guardian or others. However, there are certain things I can’t keep confidential, like if you want to hurt yourself, hurt others or if someone has hurt you. This is to keep you safe.”
  • If a private interview is not able to be standard practice in your setting, assess the need for privacy protection with all patients by asking: “Is it important to you that the information you share with me today is kept private from your parent or guardian?”
  • If yes, inform the patient when protection of privacy will not be possible, “There are certain things I can keep private if that is what you prefer. And there are certain things I have to share with another adult (like your medical team and parent/guardian), like if it affects your safety or the safety of someone else.” 

Electronic Health Record (EHR) Tools:

• Use a protected note type to document any information that needs to be confidential. Learn about the confidentiality capabilities of this note type specific to your hospital or clinic.

Medications:

• If a medication prescription is needed, problem-solve with the patient to develop a plan to obtain and store the medicine (get to the pharmacy, pay for the prescription, and keep it accessible so they use it while trying to keep it confidential at home). Can they identify a trusted adult to help them with medications?
• While some prescriptions may be ordered confidentially within your EHR, it does not necessarily mean the dispensing pharmacy has a process for maintaining confidentiality. Consider checking with the pharmacy first. 

Specifics Related to Nicotine Cessation:

• Nicotine replacement therapy (NRT) can be prescribed confidentially. See medication prescription tips above.
• Work with patients to develop a plan to maintain confidentiality, if desired, throughout their quit attempt. Suggest the inclusion of a trusted adult to help support them in quitting.

Specifics related to Sexual/Reproductive Health:

• Minor consent laws vary by state. Up-to-date information can be found here: An Overview of Consent to Reproductive Health Services by Young People | Guttmacher Institute
  • In MO and KS minors may receive care for sexually transmitted infection (STI) with privacy protection. In MO and KS minors have some limits on contraception care that can be accessed privately. In KS minors also have limits on prenatal care that can be accessed privately.
• You may order certain tests (e.g., STI testing) and medications as confidential orders. Learn about the availability of confidential orders specific to your hospital or clinic. 
• See medication prescription tips above.