Integrated care, shared electronic records, and the psychology profession: a cautionary tale for counseling centers

Abstract

ABSTRACTInadequate attention has been paid to the implications for clients and professional psychology resulting from use of electronic records in outpatient integrated care settings. Affecting clients, there have been pressures to erode longstanding protections of privacy, confidentiality, informed consent, and client self-determination regarding control of their psychological information. Meanwhile, professional psychology risks associated losses in professional values and independence. All of these developments may negatively impact counseling centers as well. Especially on campuses where there are initiatives to engage in some form of integrated care. The origins of these unintended consequences are traceable to forces in the healthcare environment that seek to have psychological information completely shared in electronic records. Specifically, there are pressures to have all psychological information about clients to be available to all medical providers. The urgency to move forward with this record keeping model is somewhat perplexing given that essential information may be readily shared without diminishing client privacy, confidentiality, informed consent, and self-determination. Professional psychology does not need to sacrifice its values and independence in order to share needed client information. The negative consequences of completely shared records for clients and psychologists are elaborated and explored. The justifications that are posed for completely shared records are reviewed. Counterproposals are offered for implementing systems and practices in which the needs of both our clients and medical colleagues may be met, the psychology profession sustains no losses, and all mutually desired objectives may be achieved.