Secure Communications with Patients and Staff now Available in CarePaths’ eRecord

CarePaths has upgraded our messaging system to include email notifications to external/personal email addresses. All users who have a valid email registered in their User Settings will receive email notifications about new messages and alerts that have been sent to their internal eRecord Mailbox.

To put it another way, given the sometimes unreliable delivery of Internet email, we are now always sending messages and alerts to a user’s internal eRecord Mailbox (for patients this is the Patient Portal; for clinicians this is their Messages link on their Home page). That delivery is much more reliable as it never leaves our application. Once delivered, the new message is available whenever the user logs in. This now includes appointment and other alerts that have previously been sent out only as email. These alert messages are also now routed through the internal mail system and now are the same messages that may be delivered to email via notifications.

Email notifications to a user’s personal email is a new feature. In the past, we only sent alert messages to user personal emails. These messages were not viewable in the application as a message nor could we always ensure delivery. Regular mail messages, from a patient to a staff for example, while readable in the application, would often sit waiting in the recipient’s Inbox unread waiting for the user to log in. Mail messages now also have email notifications, including mail messages to staff. Now when a staff or patient gets an internal mail message or alert, they will receive an email notification in their personal/external email notifying them and providing a direct link to read the message.

Because of privacy concerns, mail messages which may contain protected, personal information are not sent in full text in email notifications to external email addresses. Internet email is an inherently insecure messaging system and is not by default encrypted or authenticated in a way that prevents transmissions from being read by unauthorized persons. To balance the need to have an easy way to read mail that has been sent internally, we provide a secure link back to our application allowing users to read the full text of a mail message. Alerts are sent out full text as the content of these messages is controlled and so has much less potential risk.

Any user that wishes to opt out of email notifications to their personal email can simply visit the User Settings page by clicking their name in the upper right corner of the application and then unchecking the new “Send email notifications?” checkbox. This checkbox is directly under the input to enter their email address. Note that email notifications can’t be sent unless the user has a valid email address listed in User Settings. Staff can also update a patient’s email and notification preferences on the patient’s Account tab.

Over the next few weeks, we will be continuing to rework and integrate more features on top of this new messaging platform.

The Ethical Demise of the American Psychological Association: Is Everything for Sale?

The conscience of the American Psychological Association (APA) is slowly dying as it facilitates torture, cheats its own members, and hussles junk science boondoggles to the defense industry. But the APA wasn’t always this way. Founded in the late 19th century by the intellectual giant William James and others, it had a proud history of advancing the science of psychology, defending the rights of those served by psychology, and promoting the interests of its members.

In 2005 the leadership of the APA violated its governance rules to allow psychologists to support the Bush era torture program. This was critical because the Justice Department had ruled that a health professional needed to be present during “enhanced interrogations” and because other professional organizations such as the America Medical Association and the America Psychiatric Association had unequivocally declared these programs unethical and out of bounds for their members. A national panel of human rights experts investigated a newly released cache of emails showing the APA, with the collaboration of the White House and CIA personnel, secretly modified its ethics policy to keep psychologists involved in torture. The New York Times reported on the panel’s findings on its front page late last month. (1)

In its official response, the APA characterized the report as “recirculated allegations” and maintained that “last October we released a statement refuting these allegations.” (2) But this response is a lie. The human rights experts presented new evidence of APA support of torture and refuted earlier APA denials. One email from Kirk Hubbard, the CIA agent overseeing the torture program, gives a shout out to former APA president Martin Seligman, saying he “had helped a lot over the last 4 years.” (2) Seligman had earlier denied involvement.

The APA describes the whole issue as a “public misunderstanding” and it has reluctantly hired an attorney to investigate the matter. It intends to publish its own report after which it plans “an aggressive communications program” to set the record straight. Sounds like they’ve already decided what their investigators will find.

Deceit is baked into the APA. Over the last several decades the compensation for APA leadership and staff has become increasingly generous and secure as the ability of the members to earn a living has become more precarious. During this time the organization’s relationship to its members became increasingly exploitative.

The APA recently settled a class action lawsuit. For 24 years APA members practicing as clinicians thought they had to pay a substantial special assessment that was not charged to academic psychologists.(3) Why did clinicians think that they had to pay the extra assessment? Because the APA called the special assessment “mandatory” and said clinicians “must pay.” The APA leadership perpetrated this deception until 2011 when a disgruntled clinician learned that the mandatory assessment had never been approved.

Last month after four years and undisclosed legal expenses the APA proposed a settlement of 9.02 million dollars and agreed to change its Orwellian member communications practices. But the organization is not apologizing. According to its president, one Barry Anton, Ph.D., “we do not concede that there was any wrongdoing on our part.”(4)

A professional organization should be guided by its membership. If the members want to pay lower dues for scaled back services that should be the end of the story. A professional organization struggling in a legal battle with its membership, as if it represents something other than its membership, has clearly lost its way.

So what about the integrity of psychological science and services? More spin, deception, and bullshit as the APA shills behavioral programs to the military-security state. Building on relationships developed while crafting torture policies, APA and APA connected psychologists have spun off a series of ventures noteworthy for their pseudoscientific underpinnings, lack of real world effectiveness and high cost. Some of the programs the APA has sponsored, abetted or profited from include:

Comprehensive Soldier Resiliency Program (237 million dollars) was developed by Martin Seligman and is now deployed throughout the military . This program aims to prevent stress-related mental health problems by teaching soldiers to be more resilient and optimistic. The APA enthusiastically promoted the program in a slew of puff pieces in its peer reviewed flagship journal, the American Psychologist. But independent evaluations show the program doesn’t work. An Institute of Medicine scientific panel noted that the program was never vetted for effectiveness and could, in fact be harmful.(5) USA Today article cites “startling negative results.”(6) When USA Today confronted the Army, military psychologists went back and lowered the threshold for optimism to make the results look less bad.

Enhanced Interrogation Techniques (81 million). Two psychologists, James Elmer Mitchell and Bruce Jessen, created interrogation techniques using principals developed by the same Martin Seligman. However, this program has not only failed to elicit useful information via torture, it has blackened America’s name around the world and contributed to Middle East instability and blowback.

Screening Passengers by Observation Techniques, SPOT (900 million dollars). Developed by psychologist Paul Ekman, the program trains “behavior detection officers” to identify potential threats at US airports based on personal characteristics, behavior and facial expressions. (7) To date there has not been one verified case of a successful terrorist detection using the program.

The American Psychological Association poses as a professional organization. In truth it is a racket benefiting a few insiders. It reflects the larger society where the accumulation of money and power is the measure of success and the public good an afterthought; a society in which our president lauds bankers who impoverish millions of ordinary workers as “savvy businessmen.” The APA’s failure to fulfill its broad social mission impoverishes us all.

A version of this article appeared on Counterpunch http://www.counterpunch.org/2015/05/13/the-ethical-demise-of-the-american-psychological-association/

1. http://www.nytimes.com/2015/05/01/us/report-says-american-psychological-association-collaborated-on-torture-justification.html?_r=0

2. http://www.apa.org/news/press/response/new-york-times.aspx

3. http://www.nytimes.com/2015/05/01/us/report-says-american-psychological-association-collaborated-on-torture-justification.html?_r=0

4. http://www.apa.org/news/press/releases/2015/01/practice-assessment.aspx

5. http://www.nature.com/news/2010/100526/full/465412a.html

6. http://www.usatoday.com/story/news/nation/2015/04/16/army-survey-morale/24897455/

7. http://www.intelligence.senate.gov/study2014/sscistudy1.pdf