Among the most consequential design choices any statewide health information exchange makes is its consent model — the default rule that determines whether a patient’s records flow through the network unless they say otherwise, or only after they affirmatively agree. Arizona’s framework, grounded in state legislation enacted in 2011, established an opt-out model for statewide exchange.
Opt-out, in plain terms
Under an opt-out model, a patient’s clinical information is available through the exchange by default, and the patient retains the right to remove themselves. Arizona law established three specific patient rights: to opt out of having information shared through the network entirely, to change that decision later, and to opt out of sharing through a particular provider. Opt-in models invert the default — nothing is shared until the patient affirmatively consents.
Why the choice is not trivial
The two models trade off in predictable ways. Opt-out generally produces more complete data for treatment, because most patients do not take action to remove themselves, which matters acutely in emergencies when a clinician is meeting a patient for the first time. Opt-in offers a stronger up-front privacy posture but commonly yields sparser records, since participation depends on an affirmative step that not everyone takes. Neither is universally “correct”; each reflects a policy judgment about the balance between care coordination and individual control.
The practical consequence of opting out
Patients considering opting out should understand the trade-off honestly. Removing oneself from the exchange limits the records a treating clinician can pull in an urgent or unfamiliar situation. That is the point of the choice — it is the patient’s to make — but it should be made with the consequence in view, not as an abstraction.
The convener’s role
AzHeC does not administer consent decisions; that belongs to the exchange operator and the patient. Our role is to explain the model clearly and neutrally so that providers can answer patient questions accurately and patients can decide with real information. Our Network work area covers consent and data-sharing models in more depth, and the glossary defines the terms involved.