Consumer Consent Options for Electronic Health Information Exchange

It is extremely important that appropriate guidance in the form of higher-level principles or recommendations are used in selecting and applying a particular consent model for electronic health information exchange, according to a whitepaper developed by George Washington University under contract with the Office of the National Coordinator for Health IT.

The report describes in great detail the options regarding patient consent for exchanging data among healthcare organizations. The options include:

• No consent: Automatically allowing the exchange of records without patient consent and without an opt-out clause;
• Opt-out: Offering patients only an all-inclusive opt-out option;
• Opt-out, with exceptions: Offering varying levels of opt-outs, such as allowing only selected data to be exchanged;
• Opt-in: Requiring that patients explicitly grant permission for the exchange of all of their information; and
• Opt-in, with restrictions: Enabling patients to grant permission for the exchange of specific subsets of their records.

"While this document represents a starting point for discussion related to consent, it is imperative that future deliberations are informed by further research regarding the effectiveness and impact of various consent options, consideration of the broader policy landscape and assessment of the needs of those most affected by the consent decision," the report states.

"Until the time when we are confident that we can protect health information in a systematic and thorough way, prudent use of the mechanism of consent appears to be one of the most reliable ways to pursue that goal."

Here are links to the ONC documents:

Executive Summary

Whitepaper