Patient Care Undermined With Separate EHRs for Mental Health Notes?



Historically, psychiatric records have been kept separate from a patient’s medical records and as more organizations transition to electronic health records (EHRs), these records continue to remain separated despite recommendations that they should be shared. A recent study by a group of researchers including Adam Kaplin, MD, PhD, Assistant Professor of Psychiatry and Behavioral Sciences and Assistant Professor of Neurology at the Johns Hopkins University School of Medicine in Baltimore, found that very few hospitals in the United States even store psychiatric records electronically and even fewer share the records with nonpsychiatric physicians.

“The psychiatric illnesses these patients have play a huge bearing on their medical illnesses,” Dr. Kaplin said. “As an example, whether or not you have depression following a heart attack is as big as or bigger than any other risk factor as to whether you are going to die in the year following that heart attack.”

This is a huge issue according to Dr. Kaplin, one that prevents physicians from giving patients the complete care that that they deserve. Kait B. Roe, a patient advocate and patient engagement consultant in Washington, says:

“It is the health of the whole person that matters, and until we can get past all of this stuff that is attached to mental illness, we will never have parity in how we treat patients.”

There are many barriers to sharing records including patient concerns about privacy, separate patient consent models for physical and mental health care and technical and logistical difficulties within the EHR.

 “We are a long way from discussing the nitty-gritty of what should be shared,” Dr. Kaplin said. “But at the very minimum, other physicians should know the name of a patient's treating psychiatrist, the diagnosis, the medications he or she takes, and whether he or she is suicidal,” he said.


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