Protecting Confidentiality in Online Records of Minors at Risk of Harm: Experiences in Pediatric Oncology Care

Online record access (ORA) can engage adolescents in their care and support parents in managing children's care. However, healthcare professionals (HCPs) worry about maintaining confidentiality when documenting in minors' electronic health records (EHR). This study explored Swedish pediatric oncology HCPs' experiences of protecting minors' confidentiality in the context of ORA. Semi-structured interviews (N=13) were conducted as part of a study on oncology HCPs' views on ORA regulations. Four themes emerged: experiences unrelated to oncology, insufficient options for blocking and concealment, difficulties in documenting child maltreatment, and adapted safeguarding strategies. In conclusion, HCPs need guidance and resources to prevent safety risks without compromising note quality and care of minor patients in vulnerable contexts.