In Brief

Russ Newman, PhD, JD, executive director of APA's Practice Directorate, praised the goals of the drive to create the National Health Information Network (NHIN)--an electronic health-record database for health-care providers--while voicing APA's concerns about protecting mental health patients' special privacy needs at a March hearing about the proposed network.

The hearing was sponsored by the National Committee on Vital and Health Statistics Subcommittee on Privacy and Confidentiality, a division of the Department of Health and Human Services (HHS) that develops health data standards and establishes information privacy policy.

Although NHIN is still in preliminary stages of development, Newman asserted that the potential benefits of improving the integration of mental and physical health care are dependent on "careful and selective" access to patient's mental health records, with psychologists actively involved in the process.

To create such integration, Newman proposed a two-tiered system, in which physical health records are shared more widely than mental health records, which would have restricted access.

"Mental health is unique in that successful treatment depends on both the existence of privacy and the expectation of privacy," he said. "There is no other health field in which the mere threat of loss of privacy can interfere with the success of treatment."

Newman also pointed to a need to exclude, or limit access to, specific psychotherapy notes, psychological test materials and raw data. He also called on the subcommittee to recognize and maintain the role that licensed mental health professionals play in determining what is appropriate access to mental health records by insurers and, at times, patients themselves.

Despite the privacy caveats, Newman said the program has numerous potential benefits to health-care providers and consumers.

"We believe [NHIN] has the potential to substantially improve the quality of health care provided in this country by allowing instant access to critical patient information at any point of care," he said. "It also has the potential to increase the efficiency of service delivery and, importantly, lower administrative costs."

The subcommittee held the hearing to discuss the ramifications of NHIN, which is part of President Bush's Health Information Technology initiative. The national committee will make recommendations to the secretary of HHS as to what privacy protections are necessary for the electronic health records.