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Electronic Health Records Pose Challenge to Mental and Behavioral Health Care

Electronic Health Records Pose Challenge to Mental and Behavioral Health Care

By Patrick Hendry, Mental Health America Senior Director of Consumer Advocacy

[This post originally appeared on]

An electronic health record (EHR) replaces the traditional paper charts and records that have restricted access and sharing for many years. It is a digital record, created in real time, and instantly and securely available to authorized users. They are patient-centered records and because of their easy availability they provide patients access to them and provide their healthcare provider with feedback about possible mistakes or omissions. EHRs contain the medical and treatment histories of patients, and are designed to give a more comprehensive view of patients’ conditions and histories.

EHRs Hold Great Promise to Improve Quality of Care and Access to Information

EHRs allow access to authorized users and patients without the complications created by paper records. They include a broad range of information including medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and other test results. They form a continuous record that is added to by any or all of the medical providers a patient might utilize. This sharing of important information allows for better, more comprehensive treatment and helps prevent errors like conflicting treatments and medications. They are designed to share information with laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics–in other words, the entire spectrum of healthcare providers.

The issues of security and privacy in EHRs slowed the growth of e-health systems for many years. In order to provide security and privacy, it is important to develop new policies and procedures built around the new realities of electronic communication. Unfortunately this has proved difficult, but it is necessary if EHRs are to succeed and provide a higher degree of efficiency and access. Advocates and patient organizations have expressed concerns about the security of patients’ personal information. Behavioral health advocacy organizations have been particularly skeptical about whether these new systems will provide sufficient privacy.

Privacy Concerns Linger for EHRs in Mental Health Care

Technology has created new ethical challenges in the expansion of the use of electronic health records. A number of ethical questions have arisen with the ongoing uptake of EHRs, particularly in the area of internet-based health information and data mining. The management of health records has changed with the advent of EHRs, and a number of social and cultural issues have to be addressed. Access to personal EHRs has empowered healthcare consumers; online access has provided them with even greater ease of access, but it has also raised concerns about the security of the information. Belief in the confidentiality of a person’s health records is an important part of the efficacy of treatment and is particularly of concern to people in the behavioral healthcare system. Consumers of mental healthcare services are afraid that improper access will create increased stress and difficulty in the areas of employment, housing, and social relationships. The use of EHRs for data mining in conjunction with research and policy development is powerful, but agencies controlling access must walk a thin ethical line. It is important that healthcare workers and administrators honor the right of the patient to manage how and to whom health records can be shared. It is the duty of providers to improve the welfare of their patients, and to avoid doing harm. Overall, it is a matter of justice in the areas of self-determination and privacy.


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