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Interstate Disclosure

Due to variation in state and local policies and laws, various models for obtaining consent to use or disclose health information have been established. The Intrastate and Interstate Consent Policy Options collaborative was formed to identify and evaluate consent options for electronic health information exchange at the state level and among states.

One aspect of the Collaborative's work focused on the intrastate aspects of consent reviewed and analyzed the pros and cons of five consent alternatives: opt out; opt out with exceptions; no consent; opt in with restrictions; and opt in unless otherwise required by law. While the other aspect of the Collaborative's work focused on the interstate aspects of consent where they explored the viability of certain high-level policy options (e.g., interstate compact) that could be used across states to foster electronic health information exchange resolve conflicting state laws and requirements related to consent.


These reports document the Collaborative's findings and provide detailed information about the consent and disclosure requirements for the 11 participating states.

Interstate Disclosure and Patient Consent Requirements Final Report
  • Final Report [PDF]
    Includes a description of the collaborative project, analysis of commonalities and variations, recommendations, lessons learned, results, and suggestions for further work. Consists of 3 components
    • Project Director's Guide to using the information collection templates [PDF] [DOC]
    • Information Collection Template for Scenarios 1 and 2, Emergent and Non-emergent treatment [PDF] [XLS]
    • Information Collection Template for Public Health Scenario [PDF] [XLS]
    • Information Collection Template for HIO Policy [PDF] [DOC]
    • Appendix B: data tables [PDF] [DOC]

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