Beyond Googling: The Ethics of Using Patients' Electronic Footprints in Psychiatric Practice

Carl Fisher and Paul Appelbaum
Harvard Review of Psychiatry

Abstract

Electronic communications are an increasingly important part of people's lives, and much information is accessible through such means. Anecdotal clinical reports indicate that mental health professionals are beginning to use information from their patients' electronic activities in treatment and that their data-gathering practices have gone far beyond simply searching for patients online. Both academic and private sector researchers are developing mental health applications to collect patient information for clinical purposes. Professional societies and commentators have provided minimal guidance, however, about best practices for obtaining or using information from electronic communications or other online activities. This article reviews the clinical and ethical issues regarding use of patients' electronic activities, primarily focusing on situations in which patients share information with clinicians voluntarily. We discuss the potential uses of mental health patients' electronic footprints for therapeutic purposes, and consider both the potential benefits and the drawbacks and risks. Whether clinicians decide to use such information in treating any particular patient-and if so, the nature and scope of its use-requires case-by-case analysis. But it is reasonable to assume that clinicians, depending on their circumstances and goals, will encounter circumstances in which patients' electronic activities will be relevant to, and useful in, treatment.

The article is here.

Guidelines for Best Practices in Electronic Communications

Ontario Psychological Association
February 2015

Preamble

Preamble Technology has been changing communication between psychological service providers and patients, referral sources, other healthcare providers and third-party payers. Members may be aware of websites, applications, and email communication tools that can be used to improve the delivery of patient care. Many of us use email extensively because it is fast, reliable, and convenient. These same characteristics, however, bring legal and liability risks, including a higher potential for privacy breaches.

As regulated health professionals, we have an obligation to maintain the confidentiality of our patients' personal health information (PHI) and to comply with privacy regulations (see Appendix A). Members need to consider how to communicate with and about patients while still protecting patient privacy. While email is fast and convenient, it also is often the least secure and the least private way to communicate.

 We are aware that many larger healthcare and academic settings now have policies stating that email should not be used to transmit any PHI. We are also aware that general guidelines for use of email suggest that it is not a secure form of communication for any personal information. Most guidelines for general email use suggest that information that is sensitive, confidential, potentially embarrassing, proprietary, personal, or classified should never be sent through email.

While members practicing within healthcare and academic settings may be familiar with their institution’s policies, those in community-based practice may not be as familiar with regulations and expectations regarding electronic communication. To clarify the responsibilities of members, the Ontario Psychological Association’s Communication and Member Services Committee is providing the following Guidelines for Best Practices in Electronic Communications.

The entire helpful guide is here.