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Terry McLeod of ehrSIO ProjectsehrSIO Projects
A blog about the technical and software sides of mental health and addictions

Anonymous Struggle

Terry McLeod Updated: Feb 8th 2011

Is this anonymous?

man with question mark on faceI ran across a headline sharing the wonderful news for OneRecovery, who recently closed a deal with Aetna Insurance. Good for them, the salesperson in me cheers and applauds. For the consumer who is a member of the Aetna EAP involved in this sort of service, it means being attached to a traceable series of numbers to track usage. Before participating in programs like these, look into the security measures offered. Some are good, others may not be so great.

An EAP, or Employee Assistance Program, offers a number of services, some of which revolve around mental health and addiction services. Some EAPs offer telephone counseling with a professional, as well as other life-skills services.

Once again, our health information could be further shared due to insurance companies' "need to know"...which, incidentally, is legitimate to a certain extent. After all, when an insurance company is paying claims, it's only good business to know where the money's going. That said, if I were a consumer just trying to overcome addiction or alcoholism, I may want to guard that information from my employer; if not the fact I was frequenting a site specializing in bearing one's soul with relationship to the disease of addiction, then certainly to the details about my symptoms, relapses, etc. Recovery is a personal affair that improves lives, creates good workers and helps people become participating members of society who pay their bills. One question becomes "How do we keep recovery on that deeply personal level and still enable insurance/EAP billing without disclosing sensitive treatment details that are nobody's business but the recovering person?"

Living up to this sort of ideal can be tough, but not impossible.

On the back end of social networking for recovery support, if somebody provides a service, whether it's telephone counseling, monitoring a chat room, writing a social-networking software program or keeping the server up and running, they need to feed the baby and buy shoes. So, statistics, lots of statistics, need to change hands to assure the work's getting done and the service is proving valuable. Proving that legitimate services were provided becomes an interesting challenge, not because the statistics aren't available, but because of the details involved that really shouldn't be shared.

Many years ago, a company in New York worked with the state to assure anonymity of substance abuse treatment consumers statewide. The state needed to provide and track Medicaid services to consumers in treatment in order to assure professionals got paid and consumers received the treatment they needed without names attached. Maintaining anonymity was a problem. The solution was to hire a third party who was the keeper of the numbers and the names. The state didn't get the names of consumers, just the numbers. The idea worked fine to guard anonymity of involved consumers. The company that was hired had physical security that made it tough to get into the place. Years ago, the manager of this private, third-party facility protected the identity of a patient, not releasing records to the court and risked jail time. Security was about as good as a consumer could hope for. Every scrap of paper that might remotely be attached to a consumer was shredded, and even computer backup tapes were tightly guarded in a secure environment.

Private insurance companies aren't necessarily as concerned with confidentiality. Although they may not release records without a consumer's permission, how much information needs to pass from party to party? I'd say, just enough to validate that a service was provided by a qualified professional, who follows the rules established to protect consumers and assure treatment helps them recover.

I think the on line support groups are a good, and there are a number of them available: Here are a few:

If you're shopping, I'd suggest you ask about security, and think about how your information, intimate details about a problem that you might discuss in a chat room or on-line with a professional, might be shared with folks like insurance companies, or as de-identified data for research. What safeguards are in place to protect your anonymity?

Caution on the front end could avoid some trouble down the line.


Terry McLeod

Electronic Health Records (EHRs) are a required part of our society, and improving business workflows with the EHR is imperative for the survival of your local mental health and addictions treatment clinics. Terry McLeod provides the bridge between the mental health and addictions professional and the technical world, as well as the glue to keep it working. Contact McLeod at and get more information from his website and blog,

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