The Patient—Therapist Relationship: Reliable and Authentic Mental Health Records in a Shared Electronic Environment

There are currently a number of initiatives in Australia and internationally that are aimed at sharing patient data among healthcare providers, as well as other third parties. This article analyses the impact of one of these projects — HealthConnect — on the reliability and authenticity of mental health records by assessing the adequacy of evolving electronic health records standards, as well as mental health records standards. Although the analysis found that mental health services could benefit from the sharing of information between healthcare providers, the HealthConnect proposals and standards activity highlight the paucity of specific measures in place to differentiate mental health information from other health information. Research also indicates that current proposals do not meet record-keeping benchmarks of authenticity, which require the ability to reconstruct all elements of a record's identity and integrity over time — essential to protecting the rights and obligations of the patient, therapist and other third parties. Finally, the article proposes a technology-neutral conceptual model for identifying the trustworthiness of mental health records in a shared electronic environment.