Troubled teens could benefit from online access to health records

October 22, 2012

Online health records could be surprisingly useful for at-risk teenagers who cycle through the juvenile justice system. A new study from the Stanford University School of Medicine and the Santa Clara Valley Medical Center found that these young people have high rates of Internet use and an unexpectedly favorable attitude toward accessing their health records online.

who get in trouble with the law could particularly benefit from online health records because they generally have worse health than other adolescents—and no one keeping track of the health care they do receive. These teens' health problems range from spotty immunization histories to such as asthma, sexually transmitted infections, and substance abuse. And not only do poverty, difficult relationships with their parents and frequent moves make it hard for them to get consistent health care, these problems also increase the chances that doctors who are treating them will not have access to their .

No one knows if using online health records would be feasible or desirable for this group. The new study, which will be published online Oct. 22 in Pediatrics, shows that such an approach has great promise, despite skepticism among some providers that this population is not inclined to avail itself of online resources.

"These young people are marginalized, considered delinquent," said the study's senior author, Arash Anoshiravani, MD. "They're often not considered when it comes to new ways of engaging patients." Anoshiravani is an specialist at Lucile Packard Children's Hospital, a clinical assistant professor of adolescent medicine at Stanford and the medical director of the Santa Clara County Juvenile Custody Institutions.

Anoshiravani's team conducted in-person interviews with 79 incarcerated teens who received treatment at the Santa Clara Valley Medical Center. The researchers wanted to know whether these youth had the resources and inclination to use online health records outside of juvenile hall. (They do not have Internet access while detained.)

The teens had similar rates of Internet use to the general adolescent population, with 87 percent saying they used the Internet at least once per week when not detained. Home computers and cell phones were their most common tools for accessing the Internet, the study found. The finding contradicts older research demonstrating a "digital divide" of low Internet use in poorly educated and impoverished groups.

"Things have shifted; the digital divide still exists between older individuals of different backgrounds, but among adolescents there is a high rate of tech access, even for the most underserved," said Gregory Gaskin, a Stanford medical student who is the first author of the paper.

The U. S. health-care system is gradually replacing paper charts with computerized electronic medical records, and some providers are beginning to allow patients to access portions of the records online. The researchers wondered whether this target group of teenagers would be interested in seeing their health information on the Web.

The teens were enthusiastic about the option, with 90 percent saying it would be useful to have their health information automatically put online so they could access it later.

"I didn't expect this level of interest because they don't typically think of health as something that's part of their daily lives," Anoshiravani said, adding that these teens engage in risky behaviors that make them seem cavalier about their health.

These teens' need for reliable and accessible health records is made even more urgent because they often do not have family members overseeing health-related chores, such as tracking immunizations and medications, checking lab results or recording their medical history. The lack of records is a problem not just in the short term but also when these teens reach adulthood, especially for those who survived serious medical events in childhood. "They may turn 18 and not know they were born with a heart defect that was surgically repaired," Anoshiravani said.

Contrast that situation to a typical teenager. "A parent or grandparent is going with them to the doctor and keeping their health records," Anoshiravani said, noting that troubled teens don't have that help. And it's not realistic to expect these teens to keep a hard copy of their medical file. "Carrying around pieces of paper that they could lose did not make sense to them, but having a place to check this information online did make a lot of sense," he added.

The researchers were surprised to find that the teenagers would also share online health records: The vast majority of the respondents were willing to share their records with doctors and half said they would want to share the information with their parents.

The next step, Anoshiravani said, is to implement and test online health records for at-risk teens. The biggest challenge will revolve around the issue of information-sharing, since minors' parents are entitled to see some parts of their , while other types of records cannot be shared with parents without the patients' consent.

"It's very difficult right now to meet the spirit and letter of the law around confidential health information in the areas of reproductive and mental health for adolescent patients," Anoshiravani said. As electronic medical records evolve to include customized privacy settings, it will be easier to meet teens' confidentiality needs, he said.

Explore further: Microsoft 'vault ' open for dying Google Health records

Related Stories

Microsoft 'vault ' open for dying Google Health records

July 19, 2011
Microsoft on Monday offered its HealthVault as a new care center for digitized medical records kept at Google's dying Health service.

E-records linked to fewer malpractice claims

June 26, 2012
(HealthDay News) -- Malpractice claims dipped dramatically among Massachusetts physicians after they began using electronic medical records, according to new research, although it's not clear whether the record-keeping was ...

Study finds over 70 percent of suicidal teens don't get the mental health services they need

September 14, 2011
Suicidal teens are not likely to get the mental healthcare they need. This is according to a team of researchers at Seattle Children's Research Institute, the University of Washington (UW), and Group Health Research Institute. ...

Most teens with juvenile arthritis use complementary medicine

March 14, 2012
Seventy-two percent of adolescents with juvenile arthritis use at least one form of complementary and alternative medicine (CAM), but only 45 percent have discussions about it with their health care providers.

Recommended for you

Injuries from window blinds send two children to the emergency department every day

December 11, 2017
Most homes have them. They help keep our rooms warm or cold and even add a pop of color to tie the décor together. But window blinds can cause serious injuries or even death to young children. A new study from the Center ...

Blood flow altered in brains of preterm newborns vs. full-term infants

December 4, 2017
Cerebral blood flow (CBF) of key regions of newborns' brains is altered in very premature infants and may provide an early warning sign of disturbed brain maturation well before such injury is visible on conventional imaging, ...

HPV vaccine is effective, safe 10 years after it's given

November 29, 2017
A decade of data on hundreds of boys and girls who received the HPV vaccine indicates the vaccine is safe and effective long term in protecting against the most virulent strains of the virus, researchers report.

Antibiotics administered during labor delay healthy gut bacteria in babies

November 28, 2017
Antibiotics administered during labour for Group B Streptococcus (GBS) affect the development of gut bacteria in babies, according to a study from McMaster University.

Stress in pregnancy linked to changes in infant's nervous system, less smiling, less resilience

November 23, 2017
Maternal stress during the second trimester of pregnancy may influence the nervous system of the developing child, both before and after birth, and may have subtle effects on temperament, resulting in less smiling and engagement, ...

Molecules in spit may be able to diagnose and predict length of concussions

November 20, 2017
Diagnosing a concussion can sometimes be a guessing game, but clues taken from small molecules in saliva may be able to help diagnose and predict the duration of concussions in children, according to Penn State College of ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.