Data after death: Record keeping considerations for unexpected departures of mental health providers.

Abstract

Technologies used for record keeping have rapidly changed over the last 2 decades, with many providers shifting from pen and paper notes to electronic medical records (EMRs) and other cloud-based, digital solutions. This transition to electronic means of client data storage has resulted in greater efficiencies, improved integrated care, and loss prevention. However, moving to digital means of record keeping involves novel legal and ethical consequences, which have been reviewed by various authors (e.g., Devereaux and Gottlieb (2012) and the APA’s, 2007 Record Keeping Guidelines). Importantly, unexamined to date are concerns associated with data after death—specifically, when a mental health provider who uses technology for record keeping unexpectedly departs via incapacitation, death, or other unknown circumstances. These circumstances may prevent continuity of care and access to data among survivors. This article reviews the current use of digital record keeping, federal and state policies, legal and ethical standards, and provides forward-looking recommendations for professionals.

The Role of Personality and Top Management Support in Continuance Intention to Use Electronic Health Record Systems among Nurses

“…Consequently, investments in Information Systems (ISs) to raise the efficiency of medical systems and lower the costs of running healthcare facilities have become a significant area of focus for governments and hospitals. These ISs are used to gather patient information from diverse sources into a single digital archive [ 5 , 6 , 7 ].…”

“…Electronic health records (EHRs) have become the most used means of documenting patient data, including medical appointments, and demand for the software is growing [ 5 , 8 ]. Electronic health records have been acclaimed as a technological breakthrough capable of significantly altering the future of the healthcare industry in terms of improved service delivery and systems quality [ 9 , 10 , 11 , 12 ].…”

Mental health professionals preparing for cognitive decline and death: Denial and action.

“…A custodian can and sometimes may need to help manage our records and directives. This is one step that will always be a part of a professional will and responsibly managing cognitive decline and death (Becher et al, 2012; Cohen, 1983; Garcia-Lawson et al, 2000; Lustgarten et al, 2020; O’Donnell, 2006; Pope & Vasquez, 2016). A custodian can be an individual or a team of people.…”

“…If we were to die suddenly and/or need help with our practice, professional wills need to include information about where the custodian will find lists of our current patients and their contact information as well as guidelines that detail what we want to communicate to them. Lustgarten et al (2020) have reviewed the current use of digital record keeping, federal and state policies, legal and ethical standards in general and with regard to preparing for our death in particular. They suggest, for example, that informed consent forms that clients should see at the beginning of treatment include information and protocols about what a client can and should do if they are unable to reach their mental health professional.…”

“…Over the last 40 years, there has been a small but growing literature about the importance of mental health clinicians preparing for their death (e.g., Barnett & Johnson, 2008; Cohen, 1983; Heilbrunn, 2020; Lustgarten et al, 2020; Masur, 2018; McGee, 2003; O’Donnell, 2006; Pine, 2021; Pope & Vasquez, 2016). Many of these authors have noted that anxiety and discomfort about our impending death has complicated and undermined responsible planning (Becher et al, 2012; Masur, 2018).…”