Whose System is it Anyway? How Clients and Providers Evaluate the Impact of Session EHR Use on Communication in Mental Health Treatment.

Electronic health records are common in mental health settings. While providers often express concern that in-session computing will damage client-provider communication, some work suggests that clients do not share this worry. As the majority of this research has been conducted in medical settings, less is known about how clients evaluate in session computing in mental health treatment, and whether this pattern of discordance persists in this setting. This study describes and compares the perceived impact of in-session computing on communication in mental health treatment from the clients and provider perspective, and examined sources of variation in client ratings. Thirteen providers and 53 clients participated in this study, representing 53 unique client-provider dyads. Results suggest that providers perceived in-session computing as more harmful to communication than clients. Client ratings varied by race, age and visit type but were not influenced by how often the computer was used during session.