The Division of Gastroenterology, Hepatology and Nutrition at Children’s Hospital of Philadelphia (CHOP) is committed to helping our patients make a smooth transition from pediatric to adult healthcare. This process requires collaboration between patients, their parents, and the healthcare team, starting in young adolescence through transfer of care by age 22. To promote healthcare independence, patients and parents or caregivers can expect the following:

Starting at age 12 to 15

• Providers will introduce the topic of healthcare independence, which means patients managing their chronic condition more independently. We will work toward making sure that patients understand their conditions and treatment plans. Our goal is to provide support to maximize the patients’ healthcare independence and self-advocacy to the best of their ability. Self-advocacy means that patients learn to speak up for themselves; thus, they will be encouraged to participate in decision-making and to ask health-related questions.
• Starting at age 12, due to state and federal laws, certain categories of medical information may not be viewed by the parent without consent from the patient. Therefore, patients ages 12 and older will be required to agree to their parents’ or legal guardian’s access to medical records, including MyCHOP.
• Starting at age 14, patients may be expected to meet with their provider privately for part of their visit. 

From ages 16 to 17

• Providers will continue to support healthcare independence. During clinic visits, questions and explanations will be directed toward the patient.
• When appropriate, the impact of drugs, alcohol and nonadherence to treatment may be discussed privately with the teen.
• Future plans for school and/or work will be discussed.
• Participation in “Easing the Transition from Pediatric to Adult GI Healthcare” webinar will be encouraged.

At age 18

• Adolescents are considered adults by law, so they become the primary medical decision-makers.
• The patient can now decide who may have access to his/her healthcare records. Many of our young adult patients choose to continue to involve their families in healthcare decisions. In these situations, our social worker will request the patient’s written consent so that we can continue to discuss personal health information with family members.
• If the patient has a condition that prevents them from making healthcare decisions, families will need to consider options for supported decision-making (i.e. guardianship or power of attorney). Supported decision-making empowers individuals with disabilities by ensuring that they are the ultimate decision-maker, but are provided assistance in making decisions by family members.

From age 18 to 21

• Providers will collaborate with the patient and family to develop a plan for successful transfer of care to an adult provider to take place during a period of time when the patient is as healthy as possible.
• Providers will work with the patient and family to choose a time for the transfer of care to occur between ages 18 and 22, but no later than 22.