The use of electronic health record systems raises privacy concerns for many therapists and other mental health care workers, Kaiser Health News' "Capsules" reports.
In most cases, HIPAA privacy and security rules prohibit mental health care workers from sharing psychotherapy notes unless the patient provides consent.
However, the regulations apply only to notes that are kept in separate computer files and not to notes that are entered into a patient's EHR. Information included in a patient's EHR generally can be accessed by any health care provider within the same health care system.
Many mental health workers have expressed concern that numerous health care providers might be able to access a patient's psychotherapy notes, even if the patient has not provided permission.
Decisions about how to file patients' psychotherapy notes often are made by the hospital or health system employing the mental health workers, not by the mental health workers themselves.
Abby Greene -- a counselor at a Long Island, N.Y., methadone clinic -- said her clinic is affiliated with a large psychiatric hospital that now requires clinicians to enter notes into patients' EHRs. She said her psychotherapy notes include details about criminal activities her patients have participated in.
Greene said, "When I type information into the file and hit send, I don't feel good," adding, "I feel like this could harm someone" (Schultz, "Capsules," Kaiser Health News, 6/11).