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The issue of whether, to what extent, and how individuals should have the ability to exercise control over their health information represents one of the foremost policy challenges related to the electronic exchange of health information. The current landscape of possible consent models is varied, and the factors involved in choosing among them are complex. States and other entities engaged in facilitating the exchange of electronic health information are struggling with a host of challenges, chief among them the establishment of policies and procedures for patient participation in their exchange efforts. While some have adopted policies enabling patients to exercise individual choice, others have prioritized the needs and concerns of other key stakeholders, such as providers and payers. The purpose of this paper is to discuss in detail the issues, nuanced considerations, and possible tradeoffs associated with the various consent options to help facilitate informed decision making.


White paper prepared for the Office of Policy and Planning, Office of the National Coordinator for Health IT.

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