Starting today, parents and legal guardians of HonorHealth patients ages 12 to 17 can be blocked from having full online access to the minor’s medical records, even if it is needed in a medical or mental health emergency.
Changes to HonorHealth’s online MyChart account system were recently announced which will now allow adolescents to establish and maintain their own MyChart account. In addition, parental access to such accounts for pediatric patients (under age 12) will be automatically restricted when the child turns 12, according to company documents.
“By default, proxy access is limited to help protect patient privacy,” a HonorHealth document states.
There are two type of “proxy” options offered for parents and legal guardians by the MyChart program: Limited Access and Full Access. However, Full Access Proxy is not available unless the child is a pediatric patient (under age 12) or has turned 18 and grants someone full access.
There is no Full Access Proxy on MyChart involving adolescent patients (ages 12 to 17) “in accordance Arizona state law protecting healthcare rights of minors,” a HonorHealth spokesperson explained to Arizona Daily Independent on Thursday.
Which only leaves the parent or legal guardian of an adolescent with the option being designated a Limited Access Proxy when trying to access information via MyChart for a child they legally and financially responsible for.
Getting designated by HonorHealth as a proxy is not an automatic process. It requires the parent or legal guardian to complete a three-page application which includes a provision for computer tracking within the MyChart program.
And as the title suggests, a proxy’s Limited Access is quite limited.
For instance, the proxy can use MyChart to schedule appointments for the adolescent at a HonorHealth facility but cannot view the child’s appointment history. Further, while the proxy can view the minor’s immunization records, they cannot see any of the patient’s other HonorHealth medical information or clinical notes.
Nor can they request a prescription refill on behalf of the child.
In the meantime, a patient between the age of 12 and 17 can use their MyChart account to schedule their own appointments, obtain test results, request prescription refills, and communicate with their HonorHealth care team. They can also use their MyChart account to remove someone’s proxy status.
“Proxy access to the patient’s record can be revoked by the patient in MyChart, or upon written request at any time,” the proxy application states.
The HonorHealth spokesperson acknowledged there is no Arizona law specifically prohibiting parental access to a child’s medical records. The conflict as it involves the MyChart program is “the minor’s right, under Arizona law, to consent to treatment without their parent’s consent, knowledge or awareness,” according to the spokesperson.
As a result, HonorHealth has taken the position that they cannot provide access via MyChart to information about certain types of “sensitive treatment” for children ages 12 to 17 “without consent of the patient.”
Included among those types of treatments are pregnancy tests, substance abuse test results, diagnosis and treatment of sexual transmitted diseases, and treatment for psychological and behavioral health issues, according to HonorHealth.
Because that information is not available via MyChart, a parent would have to request a full copy of the adolescent’s medical record, for which “additional authorization will be required,” the application states.
Among those expressing concern with HonorHealth’s MyChart policy is Sen. Kelly Townsend, who pointed potential conflicts with Arizona’s Parents’ Bill of Rights as described under Arizona Revised Statute 1-602(A).
Townsend (R-Apache Junction) noted that Gov. Doug Ducey recently signed House Bill 2161 into law to amend and strengthen the “inalienable rights” of parents unless those rights have been legally waived or legally terminated. For purposes of the statute, a parent is defined as a natural parent, adoptive parent, or legal guardian of the minor.
ARS 1-601(A) currently reads “all parental rights are reserved to a parent of a minor child without obstruction or interference from this state, any political subdivision of this state, any other governmental entity or any other institution.” Among the amendments which take effect later this year is one which changed the text to read “all parental rights are exclusively reserved…”
Among the parental rights included under ARS 1-602 is the right “to make all health care decisions for the minor child,” including rights defined under ARS 15-873 (school immunizations), 36-2271 (parental consent before surgery), and 36-2272 (parental consent for mental health screening or treatment) unless otherwise prohibited by law.
ARS 1-602 as amended by SB2161 also clarifies a parent’s right to request, access, and review “all written and electronic medical records of the minor child unless otherwise prohibited by law” or unless a law enforcement official requests the information not be released because the parent is under investigation for a crime against the child.
Townsend told Arizona Daily Independent she has requested Legislative Counsel and Senate General Counsel to review whether HonorHealth’s MyAccount program violates any provision of the current or soon-to-be effective provisions of the Parents’ Bill of Rights.
If necessary, Townsend says she will refer the matter to the Arizona Attorney General’s Office, something the senator can do even if the Legislator is not in session.