Frinny Polanco Walters, MD is currently an attending physician in the Adolescent and Young Adult Medicine Division at Boston Children’s Hospital. She is passionate about promoting health education, safety, and violence prevention for all adolescents and young adults, especially those with developmental disabilities, and about advocating for policies that support greater access and better quality services to the underserved, including racial/ethnic minorities and those impacted by food insecurity. As a Congressional Hispanic Caucus Institute Fellow, she worked with health policy experts on issues affecting disadvantaged communities. While in the DC area she worked at the National Institutes of Health doing research on the importance of minority populations’ involvement in clinical trials. Dr. Polanco Walters received her medical degree in 2014 from New York Medical College, Valhalla, NY, completed her pediatric residency at Floating Hospital for Children at Tufts Medical Center in Boston in 2017, and completed her fellowship in Adolescent Medicine at Boston Children’s Hospital in 2020.
Frinny Polanco Walters, MD, MPH
Attending Physician, Adolescent and Young Adult Medicine Division, Boston Children’s Hospital; Faculty Assistant Director, Office for Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, MA
(Commonwealth Fund Fellow 2019-2021)
“Unintended Consequences: The Impact of the Cures Act on Health Equity and Adolescent Confidentiality Protections”
The U.S. Department of Health and Human Services’ (HHS) Office of the National Coordinator (ONC) 21st Century Cures Act supports the use of electronic health information in a manner that is convenient, immediate, and free to the patient. Research has shown many benefits to having access to one’s health information including improvement in the quality of health care patients receive. However, this new rule may negatively affect adolescent minor patients and other vulnerable populations— those with limited English proficiency, low health literacy, and low digital literacy—who face barriers accessing their electronic health information. I partnered with the Action for Boston Community Development (ABCD), an organization that provides comprehensive family planning and reproductive health care to tens of thousands of Boston area residents annually regardless of gender, immigration, or health insurance status.
1) Evaluate the ONC’s Cures Act Final Rule impact on health equity.
2) Examine ONC’s Cures Act Final Rule as it applies to adolescent confidentiality.
3) Educate clinicians at 20 ABCD sites to provide adolescent minors with their confidential electronic health information while also protecting adolescent privacy in the implementation of the Cures Act Final Rule.
I. Analyzed 21st Century Cures Act Final Rule and its legal and clinical implications.
II. Performed a literature review to identify considerations for the implementation of the Cures Act.
III. Presented analysis and legal implications at ABCD Clinical Advisory Council Meeting.
IV. Interviewed two ABCD site directors, one attorney, and a physician expert in consumer informatics.
I developed educational material to inform clinicians in the 20 ABCD sites how to maintain compliance with the Cures Act Final Rule while providing adolescent minors access to their electronic health information in a secured manner. Lessons learned include:
• There is significant complexity in adapting the Cures Act in all 20 ABCD sites given the unique barriers faced by each site as they use different electronic health record platforms.
• Expanding access to confidential health information to adolescent minors has the potential to promote autonomy and agency over their health care.
• Having access to notes has many benefits and potential improvements in quality of health care vulnerable populations receive.
• Digital health inequities must be addressed to avoid the exacerbation of already existing health disparities.
1) Engaging with all stakeholders (clinicians, patients, EHR experts) of the ABCD sites.
2) Develop efficient strategies to allow all patients to have access to their health information.
Preceptor: Christina Lombardo, MPH (ABCD)