Extreme care required in any move toward electronic records

Liz Kowalcyk’s article “As records go online, clash over mental care privacy” (Page A1, June 21) raises important questions about privacy as it relates to the integration of mental health care into the general medical system. The Massachusetts Psychiatric Society believes that a fundamental tenet of all health care is the confidential nature of the doctor-patient relationship. The sensitivity of psychiatric information requires us to exercise extreme care as we consider integrating with electronic medical records.

i nformation concerning diagnosis, medications, hospitalizations, and past history of suicidal or violent behavior — excluding any reference to conversations between the patient and therapist or therapy notes — may be candidates for inclusion into the general medical record.

Beyond the inclusion of such basic data, we believe that sensitive personal information is not necessary and must be afforded the maximum amount of protection. We also believe that ultimately, the patient is the owner of the medical record and is entitled to determine who, absent a legal mandate, may access his or her record.


This is a complicated matter that warrants further study, careful discussion, and thoughtful implementation. As health care reform progresses, we welcome the greater integration between psychiatry and general medicine and welcome the opportunity to work with all stakeholders to ensure the privacy of sensitive psychiatric information.

Dr. Alex N. Sabo


Massachusetts Psychiatric