Publications by authors named "Marianne Sharko"

Background: Technological improvements and, subsequently, the federal 21st Century Cures Act have resulted in increased access to and interoperability of electronic protected health information (ePHI). These not only have many benefits, but also have created unique challenges for privacy and confidentiality for adolescent patients. The inability to granularly protect sensitive data and a lack of standards have resulted in limited confidentiality protection and inequitable access to health information.

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Background: The 21st Century Cures Act mandates sharing electronic health records (EHRs) with patients. Health care providers must ensure confidential sharing of medical information with adolescents while maintaining parental insight into adolescent health. Given variability in state laws, provider opinions, EHR systems, and technological limitations, consensus on best practices to achieve adolescent clinical note sharing at scale is needed.

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Article Synopsis
  • Participants increasingly expect transparency regarding their health information collected during research, with 84% wanting their data returned to them for personal use.
  • A survey of 502 individuals revealed that email (67%) was the preferred method for receiving health data, while preferences varied based on age, education, and health literacy.
  • Researchers should provide health information in various formats and tailor sharing options to meet diverse participant preferences, especially considering differences among generations and educational backgrounds.
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Objectives: Health care providers managing the complex health needs of adolescents must comply with state laws governing adolescent consent and right to privacy. However, these laws vary. Our objectives were to summarize consent and privacy laws state-by-state and assess the implications of variation for compliance with the 21st Century Cures Act and with evidence-based guidance on adolescent care.

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Objective: To develop evidence-based recommendations for improving comprehension of quantitative medication instructions.

Methods: This review included a literature search from inception to November 2021. Studies were included for the following: 1) original research; 2) compared multiple formats for presenting quantitative medication information on dose, frequency, and/or time; 3) included patients/lay-people; 4) assessed comprehension-related outcomes quantitatively.

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Introduction: Many health providers and communicators who are concerned that patients will not understand numbers instead use verbal probabilities (e.g., terms such as "rare" or "common") to convey the gist of a health message.

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Objectives: Early hospital readmissions or deaths are key healthcare quality measures in pay-for-performance programs. Predictive models could identify patients at higher risk of readmission or death and target interventions. However, existing models usually do not incorporate social determinants of health (SDH) information, although this information is of great importance to address health disparities related to social risk factors.

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Research examining whether and how adolescent patients should gain access to their electronic health records is gaining momentum. We conducted a survey to explore diversity in adolescent privacy policies and identify common approaches in health information technology management for adolescent patients. Through descriptive analyses of survey data, we found a wide range of institutional policies regarding adolescent patient privacy, and large variations in health IT executives' baseline knowledge of access policies.

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Article Synopsis
  • A nationwide survey examined public opinion on adolescent medical privacy, focusing on parental access to 16-year-olds' medical records and the impact on discussions of sensitive issues with doctors.
  • Results indicated that while a majority (83%) believed parental access could deter teens from discussing sensitive topics with doctors, support for parental access dropped slightly when those concerns were highlighted.
  • The study suggests that even though there’s strong public support for parental access, emphasizing the importance of confidentiality could help shift opinions in favor of protecting adolescent privacy during medical care.
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Objective: Medical privacy policies, which are clear-cut for adults and young children, become ambiguous during adolescence. Yet medical organizations must establish unambiguous rules about patient and parental access to electronic patient portals. We conducted a national interview study to characterize the diversity in adolescent portal policies across a range of institutions and determine the factors influencing decisions about these policies.

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