The operating models are designed to support situations where the client is a minor, either with or without a guardian. There are differences between the operating models in social welfare and healthcare services.
- Minors and the Kanta Services – an operating model for healthcare and pharmacies (in Finnish, yhteistyötilat.fi)(opens new window)
- Kanta Services handbook on the Kanta Services for social welfare providers, 5.4 Displaying a child’s documents to a guardian acting on behalf of the child (in Finnish, yhteistyotilat.fi)(opens new window)
In Kanta’s online school, you can learn the basics of the operating models related to managing a minor’s affairs and their rights. The online course on clients under the age of 18 is intended for professionals in the social welfare and healthcare sector and pharmacies. It is also suitable for students in these fields. The online course is free of charge and takes around 40–60 minutes to complete.
Guidelines for healthcare professionals
The assessment of a child’s decision-making capacity affects things like the information about the child that is displayed to their guardians in MyKanta. That’s why it is important that you always record children’s data carefully and correctly.
The healthcare professional must always assess the minor’s decision-making capacity in a treatment situation. Always assess a child’s decision-making capacity on a case-specific basis, taking into account the minor’s age, level of development and the issue regarding their care. For younger children, you can base your assessment on the developmental level generally inferred from their age.
Record your assessment of the child’s decision-making capacity by selecting whichever of the four options for structured recording best corresponds to the outcome of the assessment. This information must be recorded with each service event (appointment, follow-up or remote contact) and prescription.
If you consider the minor to lack decision-making capacity, their data will be disclosed to their guardian. In such cases, the guardian will be able to view the child’s data in MyKanta.
If you deem a minor to have decision-making capacity, they can decide for themselves whether their guardian can have access to their data. A minor may deny the sharing of data concerning an appointment, course of treatment, or a prescription with their guardians.
Structured data entry of the assessment of decision-making capacity
If you have an information system that records a structured assessment of decision-making capacity, enter the value corresponding to the assessment in the child’s record. The options are as follows:
- Value 1: Minor not competent to make decisions; data will be shared with guardians
- Value 2: Minor competent to make decisions; allows data to be shared with their guardians
- Value 3: Minor competent to make decisions; denies consent to sharing data with their guardians
- Value 4: The minor’s decision-making capacity is unknown; no data will be shared with their guardians.
You can only use value 4 in specific, restricted situations Using this value prevents the data from being displayed to guardians in MyKanta, regardless of the child’s age. This value is intended for situations where you have not yet been able to assess the minor’s decision-making capacity. Nevertheless, always assess the child’s decision-making capacity as soon as possible and change the entry to reflect your assessment.
The default value of 1 can be used in patient information systems for children under 12 years of age. Nevertheless, always assess the minor’s decision-making capacity and change the default value to reflect your assessment as necessary.
Data of a child over 10 years of age that does not include information about the minor’s decision-making capacity and their will to share their data will not be visible to the child’s guardians in MyKanta.
If you do not have an information system that records decision-making capacity assessments as structured data entries, follow THL’s guidelines on displaying data and acting on behalf of a minor in MyKanta: Guidelines for healthcare professionals (pdf, thl.fi, in Finnish)(opens new window).
If you assess that a minor can decide on processing of their data themselves, please provide them with the information about the Kanta Services at the time of their appointment. What matters is the ability of the minor to understand the principles of data sharing and the implications of the declarations of intent on the use of their data. When providing the minor with the information, tell them if their guardian has set denials of consent to data sharing regarding their data.
Once a minor who has been assessed to have decision-making capacity has been issued the information about the Kanta Services, they can give or update their consent to the sharing of their patient data when managing their affairs at healthcare services. They can also set denials of consent to the sharing of their data to determine which of their data may not be shared, for example, with another wellbeing services county or between public and private healthcare services.
A minor can only give their consent to data sharing or set up a denial of consent to data sharing when managing their affairs at a healthcare unit. They cannot set them in MyKanta. However, a minor who has been provided with information about the Kanta Services can give their consent to the sharing of patient data with other European countries in MyKanta.
A minor can, if they wish, withdraw, amend and review the consent and denials of consent to data sharing set by their guardian.
Guardians can give and withdraw consent on behalf of their child if the child has not yet been assessed as having the decision-making capacity to decide on the processing of their data. When managing affairs at a healthcare unit, guardians can also set up denials of consent to data sharing on behalf of their child. A guardian can set up denials of consent on their own or together with their child.
A guardian cannot set a denial of consent to the sharing of data that is required for the treatment of an illness that poses a threat to the minor’s life or health. When you enter a denial of consent to data sharing for a service event, check that the event does not contain such information. Always indicate that an emergency search is allowed.
A guardian cannot set up denials of consent to data sharing for data for which the minor themselves has set a denial of consent to data sharing with their guardians.
In MyKanta, guardians can receive the information about the Kanta Services and give consent to data sharing on behalf of their child under the age of 18. However, they cannot set any denials of consent in MyKanta or withdraw consent to data sharing on behalf of their child.
Guidelines for social welfare professionals
Minors’ social welfare services client data will become available in MyKanta in stages. The data will start to be visible in MyKanta once the necessary changes have been made to information systems.
Client data will gradually start to be shared between social welfare service providers. Read more on how minors can influence have a say in how their data are shared.
As a general rule, the guardian of a child under the age of 18 has the right to see their child’s client data in MyKanta, based on guardianship. According to the law, the guardian’s duty is to safeguard the child’s development and wellbeing. The guardian therefore has the right to decide on the child’s care, upbringing, place of residence and other personal matters.
The child’s data may also be viewed by another person who has the right to access information about the child's affairs, for example, under a shared-custody agreement. The person entitled to access information may be the child’s non-custodial parent or a guardian who has no decision-making rights in matters relating to the child’s social welfare.
If you assess that a minor can make their own decisions about how their data are processed, please provide them with the information about the Kanta Services at the time of their appointment.
A minor who has received the information about the Kanta Services can give or update their consent to sharing their social welfare client data when managing their affairs in social welfare services. They can also set denials of consent to the sharing of their data to determine which of their data may not be shared with e.g. another wellbeing services county or between public and private social welfare services.
A minor can only give their consent to data sharing or set denials of consent to data sharing when attending social welfare services appointments. They cannot do this in MyKanta.
A minor can, if they wish, withdraw, amend and review the consent and denials of consent to data sharing set by their guardian.
You can restrict what minor’s data is displayed to their guardians in MyKanta on a case-specific basis. There must always be a compelling reason for restricting the display of data. Always indicate in the minor’s documents whether or not the documents will be shown to the minor’s guardians.
Inform the minor of their right to prohibit their data from being shown to their guardians. If the minor requests that the data not be shown, assess whether the request can be approved. In your assessment, take into account the minor’s age, development level and the reason for their appointment.
You should also always assess whether it is necessary to restrict the sharing of data with guardians, even if the minor does not prohibit or request this.
Guardians can give consent on behalf of their child under the age of 18 if social welfare services have assessed that the child is not able to decide on the processing of their data.
Once the necessary changes have been made to information systems, guardians will be able to edit consent to data sharing and set up denials of consent to data sharing at social welfare services appointments. However, guardians cannot set up denials of consent to data sharing for data that the minor themselves has prohibited from being shared with their guardians.
In MyKanta, guardians can give their consent to the sharing of their child’s data if they have first received the information about the Kanta Services on the child’s behalf. However, guardians cannot set any denials of consent in MyKanta or withdraw consent to data sharing on behalf of their child.