title: Openness of patients' reporting with use of electronic records: psychiatric clinicians' views.
abstract: OBJECTIVE
  Improvements in electronic health record (EHR) system development will require an understanding of psychiatric clinicians' views on EHR system acceptability, including effects on psychotherapy communications, data-recording behaviors, data accessibility versus security and privacy, data quality and clarity, communications with medical colleagues, and stigma.
  
  
  METHODS
  Multidisciplinary development of a survey instrument targeting psychiatric clinicians who recently switched to EHR system use, focus group testing, data analysis, and data reliability testing.
  
  
  METHODS
  Survey of 120 university-based, outpatient mental health clinicians, with 56 (47%) responding, conducted 18 months after transition from a paper to an EHR system.
  
  
  RESULTS
  Factor analysis gave nine item groupings that overlapped strongly with five a priori domains. Respondents both praised and criticized the EHR system. A strong majority (81%) felt that open therapeutic communications were preserved. Regarding data quality, content, and privacy, clinicians (63%) were less willing to record highly confidential information and disagreed (83%) with including their own psychiatric records among routinely accessed EHR systems.
  
  
  CONCLUSIONS
  single time point; single academic medical center clinic setting; modest sample size; lack of prior instrument validation; survey conducted in 2005.
  
  
  CONCLUSIONS
  In an academic medical center clinic, the presence of electronic records was not seen as a dramatic impediment to therapeutic communications. Concerns regarding privacy and data security were significant, and may contribute to reluctances to adopt electronic records in other settings. Further study of clinicians' views and use patterns may be helpful in guiding development and deployment of electronic records systems.
authors.affiliation: Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee 37212, USA. ron.salomon@vanderbilt.edu
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Salomon
authors.forename: Jennifer Urbano
authors.initials: JU
authors.lastname: Blackford
authors.forename: S Trent
authors.initials: ST
authors.lastname: Rosenbloom
authors.forename: Sandra
authors.initials: S
authors.lastname: Seidel
authors.forename: Ellen Wright
authors.initials: EW
authors.lastname: Clayton
authors.forename: David M
authors.initials: DM
authors.lastname: Dilts
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Finder
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016494:Computer Security; D003219:Confidentiality; D030881:Disclosure; D057286:Electronic Health Records; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011570:Psychiatry; D013811:Psychotherapeutic Processes; D013714:Tennessee