Kith + Kin


The Donut Hole of Adolescent Patient Portals

Did you suddenly lose access to your teen’s patient portal(s)? Yes – that’s a real thing! And many parents aren’t aware of it, so if this is the first you’re hearing about it, you’re not alone.


What happens to parents’ access to a child’s medical records between ages 12-18?

The “Donut Hole” of adolescent patient portals is a challenge that both parents and healthcare providers alike face when trying to protect adolescent patients’ sensitive treatment information while, at the same time, recognizing that parents/guardians need some form of access to their teenager’s medical records and patient portal accounts. 


Federal, State and even some local privacy laws play a role in ensuring adolescents can access confidential healthcare services without their parents’ involvement.  Adolescents have the legal right to receive confidential healthcare in certain areas such as primary care, psychiatry, adolescent medicine, and gynecology – and they have the right for that information to be withheld from their parents or guardians.  


So if your child has recently turned 13, 12 or perhaps even 11, you may be surprised to no longer see their medical records the next time you log in. Some electronic medical records systems have the ability to provide selective access to parents and filter out the information that is legally considered sensitive (such as sexual health, sexually transmitted infection testing, substance use, and mental health). In those cases, parents will continue to have access, but may not be able to see everything you used to. Providers with patient portals that do not have the capacity to filter access to sensitive information may need to completely deny parental portal access to their adolescent child’s account unless the adolescent patient authorizes access to their protected information.


What do I need to maintain access to my child’s health records? 

Parents can obtain or are generally granted by default pediatric proxy access when the child is roughly 0-12 years old, which grants them access to all the information in their Electronic Health Record (EHR). Once the child reaches approximately 11-13 years old (again, depending on state and local law), the adolescent must provide authorization for their parents to access the portions of the record that are confidential as noted above. In most cases, adolescents can also apply for their own patient portal access at age 13, which grants them access to their confidential information and other components of their medical record.


When adolescents reach age 18, parent access is discontinued in its entirety, but parents can apply for what is referred to as proxy access, which must be approved by the adult child. Proxy access allows a person to use the patient portal to view another person’s information. Each practitioner or health system may have their own proxy access process, which only provides access to their portal (but not ALL of your child’s records that may reside in other medical records systems for other providers.)  


It’s important to note that proxy access does not always guarantee a physician will disclose health information to you directly, which is why we also recommend having your young adult sign a HIPAA consent form (Forbes has an excellent overview of this and other key forms for adult children). We suggest that you have this form and keep it handy (hopefully in Kith + Kin) to ensure you’re able to be part of the decision making process in the case of a health emergency. 


In short, your child has the right to “some privacy” starting at age 11-13 and total privacy at age 18. It’s important to have an open discussion with your child about your having access to their health information, both as a teen and a young adult.  Being armed with the knowledge of how this works and what you need to do to access information is critical to being an informed parent and an effective advocate for your family.  

© 2023 Kith + Kin