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Introduction: Privacy of Mental Health Records

Mental health records are general health information that falls under the Protected Health Information (PHI). As such, mental health records must remain confidential at all times unless for minimal situations, and often patients must authorize the disclosure of their health information. It is essential for the patients to access their health records in the course of their treatment.

Setting Description

Although the passing of the HIPAA act (Health Insurance Portability and Accountability Act) in 1962 gave patients the rights to review their health information, there are often practical challenges that limit access to these records, mainly because of the continued use of paper records (Lemke et al., 2017). The privacy of mental health records and the overall management of mental health records by clinicians, nurses, physicians, and other health professionals has become a primary concern among the patients, parents, caregivers, and guardians. Documentation and storage of mental health records are critical to the patient's progressive medication and the patient's recovery. Sharing information among healthcare providers often breach privacy rules concerning mental health information (Lemke et al., 2017). Diagnosis and treatment record is vital for the health care providers to confidently and adequately provide the desired quality of care. Limiting patient's access to mental health records may hamper the best result. Improperly documented, stored, or shared medical records are significant concerns in many mental health facilities.

Statement of objectives

While mental health records' privacy remains crucial, healthcare providers, including clinicians and physicians, must understand the best practices that ensure information privacy without limiting these records' access to mental health patients. This lobbying plan's primary objective is to determine and lobby for the best practices in handling mental health records as stipulated in the HIPAA act and other health regulations. Transparency and accountability, as well as confidentiality as well as proper documentation of health records, are critical concerns and objectives of this plan. This plan also seeks to lobby for the use of electronic health records and transparency policies in maintaining mental health records for enhanced privacy of health information in mental health settings.

Discussion

The research by Nardi, Waite & Killian (2012) reveals that more than 70% of hospitals in the united states have implemented EHR (Electronic Health Records) systems. As such, clinicians and health care systems are increasingly reviewing the concern on the best methods to share health information with the patients.

Findings and areas that need to be addressed

HIPAA grants patients the right to "inspect, review and correct or receive a copy of their health information." In light of this, healthcare professionals and hospitals must provide a transparent and accessible avenue for patients to revisit their mental health records (Harman, Flite & Bond, 2012). The law also requires healthcare providers not to charge extra fees or review of the health records to the patients. While understanding that mental health records are very confidential, their privacy must be guarded dearly. However, at least one in every four hospitals is yet to implement electronic health record systems. A lot of paperwork continue to hinder patients from accessing their mental health records (Hills & Richards, 2014). Although psychotherapy notes should be held separately from the patient’s health records, some hospitals combine health information with the psychotherapy notes. While restricting the review of psychotherapy notes by the patients, clinicians deny patients access to their mental health information that is improperly included in the psychotherapy notes.

Current legislative and professional actions

Because mental health record is considered highly confidential, both the law and profession requires a written consent by the patient before sharing with other parties. However, mental health records, like other medical information, may be shared without the patient's consent in very limited situations. For example, a psychotherapist may share mental health records to law enforcement agencies if “the psychotherapist thinks that the patient is a critical danger of violence to a reasonably predictable victim. Cal. Welf. & Inst. Code §5328(r)” (Kahn, Bell, Walker & Delbanco, 2014). If the healthcare provider has shared a patient's mental health information without the patient's consent, the provider must make a written entry in the patient's health record. The entry should consist of the date that the disclosure was done and the circumstances that influenced the disclosure, and the person or agency's names with whom the information was shared. Besides, the entry must also contain the information disclosed (Señor, Fernández-Alemán & Toval, 2012). The healthcare facility is also required to provide a copy of this entry to the patient.

An individual may file a civil case against any person who knowingly and willfully discloses confidential information. In such a case, the accused may be fined a penalty of $10,000 or three times the damages caused (Señor, Fernández-Alemán & Toval, 2012). One may also file a civil suit against a person who negligently discloses confidential information. In the case of negligence, the accused would be fined $1,000 and the amount equal to the actual damages resulting from the disclosure. An individual is also legally allowed to bring an action seeking to stop another person from sharing confidential information. According to Cal, the accuser is entitled to the attorney fees and court costs incurred in all these situations. Welf. & Inst. Code §5330 (Gajanayake, Iannella & Sahama, 2012). Besides, one may invoke the HIPAA act and file a complaint against the healthcare provider where the provider would be fined $100 for every violation and a maximum of $25,000 for similar violations repeated in a single year. Depending on the violation, the offense may be considered criminal, attracting a liability ranging between $50,000 with a year in prison and $250,000 with a ten-year jail term.

Examples of functional and non-functional areas that need to be changed

The above findings reveal various functional and non-functional areas that require some changes for efficiency and increased privacy on mental health information. Some of the functional areas include making the corrections on the patient's records as requested by them. Typically, patients may request changes to their medical records from time to time as they review their health information (Kaplan, 2012). Most healthcare providers accept to make corrections on the patient's health information whenever the patients make such requests. Another example of a functional area is installing electronic health systems and professional discretion that determine when and what information should be released. More than 70% of all hospitals across the united states have installed electronic health systems. However, some systems need to be changed to meet other patients’ demands (Nardi, Waite & Killian, 2012). For example, some of the systems incorporate psychotherapy notes with the patient's health information making it hard for them to access their medical records because the psychotherapy notes should be separated from the patients’ information.

Another area that needs some changes is the rules of access to the patient's mental health records. It is apparent that the patient's mental health record is very confidential and private and hence requiring high-level privacy (Bourgeois, Nigrin & Harper, 2015). Sharing of patients' mental health records is only allowed with permission from the patient or their legal representative. As such, it is only a legal representative, and the patient may access mental health records. Access to mental health information is a critical area of concern that requires considerable changes to ensure privacy. Healthcare providers must seek the patient's consent before sharing a health record with either another healthcare professional or a health plan when seeking help in continued medication or even billing.

Regulations on medical charges for critical services while a patient has arrears on previously rendered services form another area of concern. Sometimes patients may request some services besides having not fully paid for previously offered services by the healthcare provider (DeCarlo Santiago, Kataoka, Forness & Miranda, 2014). For instance, patients may request to review their health information or search for a record in their health information. Although the healthcare providers should not charge or deny a patient to review the patient's information, they may charge a fee as reimbursement of charges incurred in mailing or duplicating health records. Permitted charges constitute one of the non-functional areas that require changes to ensure transparency and improved privacy for mental health information.

Action

Resources for implementing the plan

One of the most critical resources for implementing this plan is the mandatory installation of electronic health record systems by all hospitals and health facilities. While noting the importance of the EHR system, healthcare facilities will be able to provide mental health information to the patients as necessary. Another resource that would positively be necessary for implementing this plan is a medical portal where the patient can easily view health records and ask for the necessary corrections in real-time. Successful implementation of this plan also requires adequate security measures, including firewalls, antiviruses, and malware detectors to limit unauthorized access to the systems.

How implementation will enhance services

The implementation of this plan can positively enhance the transparency between the health providers and the patients. Often, patients increase their trust with the providers depending on the kind of information and their relationship with the providers. Besides, increasing the accessibility of mental health information will make them aware of their condition and contribute more information to their treatment (Kaplan, 2012). The implementation of electronic health records will hasten the medical processes while improving overall service delivery.

Examples of measurable improvements

An example of measurable improvements in implementing this plan is the patients' frequency of complaints concerning their privacy or disclosure of confidential data (Kaplan, 2012). Another way of measuring this plan's efficacy is the reduction of lawsuits by the patients regarding the disclosure of their confidential information.

Conclusion

Privacy of health information is one of the critical aspects of improved healthcare service delivery. However, professional discretion and negligence often influence the unwarranted disclosure of patients' mental health information. Many hospitals leave mental health information at risk of being leaked to other people by failing to implement electronic health record systems. On the other hand, negligence among the clinicians influences the sharing of confidential information to third parties. Some healthcare providers sometimes deny the patients access to their mental health information because of the outstanding bills for previously offered services. However, the existing laws and this plan insist that healthcare providers should not deny patients access to their healthcare information.

Patients have the right to their mental health information, and thus, the healthcare providers must provide them as requested. However, they apply some charges only on costs incurred in the process, such as mailing or printing costs. Notably, some providers combine psychotherapy notes with patients' health information, making it challenging to access the patients' information. Psychotherapy notes must be separated from the other patient's health information to ensure efficiency. Denying patients chances to review their health information make the hospital to maintain wrong information concerning the patient. This plan recommends the implementation of web portals in addition to electronic health records to ensure that the patients may review and request corrections of their medical information in real-time. Of importance, patients have the right to sue individuals and the facility for any disclosure of their mental health information without their consent or updating them about any disclosure of confidential information. Individuals may invoke HIPAA or other regulations while filing lawsuits for privacy violations. Successful implementation of this plan may be measured by reduced lawsuits concerning privacy breaches and declined complaints by the patients regarding the denial of access to health records.

References