Viewpoint: OpenNotes poses ethical challenges for pediatricians

The OpenNotes movement poses a particular set of ethical concerns for physicians treating pediatric and adolescent patients, according to a recent article published in the journal Pediatrics.

OpenNotes is an international movement that encourages physicians and nurses, among other healthcare providers, to share clinical notes with patients online through secure patient portals. The movement aims to overcome challenges patients may face when attempting to gain access to their clinical notes, which they have a legal right to review under HIPAA.

Today, OpenNotes reaches more than 21 million patients in the U.S. While this increased transparency offers many benefits for patients and providers, pediatric patients pose a unique situation — notes released via patient portal will typically also be shared with the patient's parent. The authors noted an adolescent patient might be interested in keeping certain information, such as contraception, private from their parent.

One recommendation the authors offered would be to allow physicians to share select notes with only a subset of patient portal users. However, not all EHR vendors or hospitals offer this capability.

"As the movement toward transparent notes (OpenNotes) grows, clinicians and healthcare organizations caring for pediatric and adolescent patients wrestle with how to document confidential and sensitive information," the authors wrote.

To access the article in Pediatrics, click here.

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