Maintaining the confidentiality of computerized mental health outcome data

Abstract

The emergence of managed behavioral health care has increased the value of data describing outcomes of mental health treatment. At the same time, increased development of the national information infrastructure and other computer linkage systems has facilitated the flow of information among a wide network of data systems. These two developments create a dynamic tension between the need to share information and the need to protect the privacy of mental health clients and the confidentiality of their computerized records. This problem is exacerbated by the cost associated with potential solutions. Unfortunately, policy development in this area has lagged behind rapid developments in technology. The mental health administrator must balance the three components of this conflict (the increasing need for information transfer, the protection of confidentiality, and cost) without a great deal of guidance. This article offers recommendations that may help the mental health administrator manage this conflict.

An updated account of the ethical and legal considerations of record keeping.

“…For example, records may be massively distributed through the activation of a "virus" or a skilled hacker (Truscott & Crook, 2004). The privacy of clients is also threatened through the use of third parties to repair computers and the ability to revive deleted documents (Wedding, Topolski, & McGaha, 1995). For further discussion of the impact of electronic records on client confidentiality, see Richards (2009).…”

Confidentiality measures in mental health delivery settings: Report of US health information managers

“…This established process of providing efficiencies in the face of large amounts of data is not likely to be abandoned, even with the advent of more formalized and proven technology efficiencies. [15][16][17] Paper records, as well, have a long and established library of indicators and benchmarks that have come to be culturally accepted as signs of validation and/or reliability. In medical malpractice litigation, for example, evidence of erasures, notes handwritten in different shades of ink, or inconsistent spacing of handwriting is often used to suggest the alteration of paper medical records.…”