Electronic Health Record Adolescent Confidentiality in a Safety Net Setting.

Background: The 21st Century Cures Act provides improved access to one's medical record but presents new challenges to adolescent confidentiality in the domain of health care information technology. Adolescent patients, who have the right to confidential care in certain areas as dictated by state law, face the prospect of parents and guardians erroneously accessing their confidential health information.

Objectives: Our institution, the largest safety net hospital in our region, sought to quantify the proportion of adolescent patient portal accounts likely being accessed by guardians and to implement corrective measures for the patient portal sign-up process in our electronic health record (EHR) system.

Mammographic screening and disease presentation of breast cancer patients who die of disease.

This retrospective study assesses the presentation of breast cancer patients who died of disease. The goal was to estimate the proportion of patients whose cancer was detected by a screening mammogram, yet still proved fatal, and to characterize contemporary fatal breast cancers. Patients who died of breast cancer between 1995 and 2001 and were treated at three hospitals with complete, accessible information were identified using the Rhode Island Department of Health database and State Cancer Registry.