Policy Statement: All health care information of Individuals shared through the North Dakota Health Information Network (NDHIN) will be available for access by participating health care providers through the NDHIN unless an Individual opts out of participation.

Definition of Individual

For purposes of this policy, an Individual shall mean a person who is the subject of Protected Health Information (PHI), and shall have the same meaning as the term “Individual” as defined in 45 CFR § 160.103 and shall include a person who qualifies as a personal representative in accordance with 45 CFR § 164.502(g).

Definition of Participant

A Participant means an organization, health care practitioner or institution, health plan, or health care clearinghouse who has executed a written Participation Agreement and Business Associate Agreement with the NDHIN.

NDHIN Information

At the point of care, an Individual or Individual’s representative must be provided with written information in plain language about the NDHIN. The material shall describe the benefits of participation, risks of participation, how and where to obtain additional information, contact information, and a description as to how the Individual’s health information will be used.

Individuals must be informed that they have the right to opt out of participation and a right to change a prior election and must be provided information on how to exercise those options, at no cost to the Individual. If an Individual later changes a prior election, the Participant receiving the new election shall maintain that documentation and shall notify the NDHIN of the change.

Effect of Opt Out

If an Individual opts out of participation in the NDHIN, that Individual’s information will not be able to be searched for through the NDHIN in the future. However, a treating health care provider will still be able to select the NDHIN as a way to receive that individual’s lab results, radiology reports, and other data sent directly to any treating health care provider that the provider may have previously received by fax, mail, or other electronic communications. Even if an Individual opts out of participation, limited information may be disclosed through NDHIN if subject to mandatory public health reporting and child immunization information. Minimal identifying information about the Individual will also be maintained in master patient index.

An Individual may opt out of participation with an exception providing permission to access health information in the case of a Medical Emergency or if a disclosure is required by law.

Provision of Coverage or Care

A Participant may not withhold coverage or care from an Individual on the basis of that Individual's choice to opt out of participation in the NDHIN.


If an Individual’s health information is available through the NDHIN a Participant may assume the Individual has not opted-out of participation.


A minor, who may under North Dakota law consent for certain treatment without parental consent, may restrict access to information relating to treatments that a minor may obtain without parental consent. In North Dakota a minor age 14 and over may consent to treatment for sexually transmitted diseases, alcohol and drug abuse, pregnancy testing, and certain prenatal care.

A person who has authority to consent to the provision of health care to a minor is authorized to act as a personal representative.

When a minor reaches the age of majority or is emancipated, access or exercise of control of the minor’s health information by a parent or legal guardian will cease. When a minor reaches the age of 18 the minor has the right to participate or opt out of participation in the NDHIN.

If a parent opted out of participation of the NDHIN on behalf of the minor that election will remain in effect following the minor’s reaching the age of majority until the Individual makes a change to a prior election.