Patient Consent

Version 21.0

Permission to Submit Vaccine Information to Local Immunization Registry

On the Demographics > Privacy/Sharing tab in a patient's chart there is a drop-down menu. The default Consent Status is set to "Not Documented"

Note: It is the practice's responsibility to know if their Registry is OPT-IN, OPT-ALL, or OPT-OUT.

  • Registry is OPT-IN: This means that the registry will only accept vaccine data for patients who have a "Documented Consent". If the dropdown is set to "Not Documented," this patient's immunization data will not be sent to the registry.
  • Registry is OPT-ALL: This means that the registry requires all patients to be transmitted. The patient data will get sent to the registry regardless of their selection.
  • Registry is OPT-OUT: This means that the registry expects all patients who didn't explicitly refuse to have their vaccine data shared.

Note: Registry can be OPT-IN, OPT-OUT, or OPT-ALL for different patient age brackets, or different time periods.

Patient Rights regarding Immunization Registries

Every state or locale has its own patient privacy laws; registries dictate what an EHR vendor must support. For more detailed questions please contact your registry. 

The three categories are as follows:

  1. OPT-IN: If a locale is opt-in it means the patient must have explicitly provided consent to either the provider or the registry to have their vaccination records shared with the registry and/or other outside entities.  Should the provider fail to inquire, or the parent fails to submit any documentation the default behavior is for the patient's records to NOT be shared.
  2. OPT-OUT: This is the most common option.  This is very similar to OPT-IN with one key difference.  If provider fails to inquire about the patient's willingness to share records or the parent fails to submit paper work then the patient's records WILL BE shared.  The patient does have the right not to share their records but they must explicitly request to do so.
  3. OPT-ALL: This is the most relaxed option.  The patient does not have the right to prevent their records from being shared.

Patient Consent in Office Practicum

Providers should be marking the patient's privacy preference down in Office Practicum on the Patient Register > Privacy Screen.  It is important to treat this field simply as a "preference" as it is not the de facto documentation that says "I DO NOT WANT AND YOU AGREE NOT TO SHARE MY RECORDS".  Most registries have paperwork that needs to be filed by either the parent or the provider in order to effectively "OPT-OUT" of data sharing.  It is very important to note that the "Unanswered = Not asked / don't know; use registry default" is the default value for all patients and the "registry default" will mean the patient's vaccination records will be blocked from ever going to the registry if the registry is OPT-IN.

My state is OPT-ALL, so why should I care about setting this flag at all?

This is a valid question that is difficult to answer.  Most states that are OPT-ALL or OPT-OUT are not likely to change their policies. However, should the local government entity decide to impose more strict data sharing requirements on providers by switching from OPT-ALL to OPT-OUT/OPT-IN, then all of a sudden none of the provider's patient vaccination records are eligible for transmission.  If the provider receives documentation of the patients willingness or unwillingness to submit to the registry they should always set this flag.  This check-box ultimately gets mapped to the Patient's Protection Indicator within the registry.  The Protection Indicator may mean different things to different registries.  To some it may mean the registry is allowed to have it but outside entities are not, to others it means the registry should not load the vaccination data into the registry.