The effectiveness of donor registries as advance directives depends in large part on the ease with which OPO, hospital, and law enforcement personnel are able to access the databases. State legislation stipulating 24-hour access, toll-free 800-numbers, and/or World Wide Web access eases access to registries, and furthers registry development. Many states currently do not have a 24-hour accessible registry, which could substantially diminishing registry utilization. General consensus exists in the procurement community that registry information must be readily accessible at all times if it is to be useful in the actual implementation of advanced directives.
Because protection of privacy remains a key public concern, this must be taken into account when developing legislation in the area of registry access. Potential measures to alleviate these concerns include clearly establishing the entities or individuals having access to the registry, ensuring transparency of the policies regarding access and who has access, and developing mechanisms to confirm that those accessing the registry information have a right to do so.