Who Can See Your Mental Health Records? The Answer May Surprise You

Electronic medical records sounded like a great idea when the idea first began to take hold. Electronic records would streamline medical care and allow your oral surgeon to see what medications your heart doctor had prescribed, eliminating drug interactions and doctor shopping. Insurance companies and hospitals would benefit from clear and concise records that could be accessed any time from any medical facility within your network. No one predicted that the reality would be your gynecologist having full access to your psychotherapy records.

The issue of whether all your doctors should have unlimited access to medical records that ordinarily cannot be shared with anyone except under a court order was a hot topic at the recent Health Privacy Summit. Many practitioners, especially mental health specialists, expressed their concerns about who has access to therapy notes that are entered into electronic health records. In most cases, the answer is virtually any other doctor you see from that moment forward. Every doctor within your health system can access your records and legally read them.

You would expect such an invasion of the traditional bond of confidentiality between a patient and therapist to be a violation of HIPAA, the health privacy act. However, a loophole in HIPAA actually allows this breach, rather than preventing it.

For independent mental health specialists, the solution may be to avoid electronic records altogether and stick to more easily-controlled paper files. Unfortunately, for those professionals who work for clinics or hospitals, or who are a part of health networks, such decisions may not be theirs to make. As these systems make electronic medical records mandatory, therapists are losing control over their patients' records.

As with many privacy issues, electronic medical records solutions are elusive. One possible answer would be for hospitals and health care systems to begin allowing therapists and psychiatrists to create electronic medical records but keep them separately from the patient's other medical records.

According to experts, large health care systems have little incentive to allow this, however. Having everything together in one file makes it easier to bill insurers and simplifies record-keeping. If patients want to make sure their mental health records remain confidential, they must see to it that the HIPAA loophole is closed or find a way to make sure the large corporations behind their healthcare providers have an incentive to guard patients' privacy.