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What that sentence promised — and what’s actually happening to it There’s a sentence nearly every clinician has said, in some form, thousands of times: your information is confidential, and it’s used for your care. For most of the history of this profession, that sentence was simply true. The record stayed in the chart. The chart stayed in the clinic. Confidentiality had edges you could point to, and consent described something both people in the room understood. This post is
The brief argues that this linked, longitudinal object may no longer be adequately governed as an anonymised case. It proposes calling it a Digital Subject Representation (DSR) and suggests that it may warrant a dedicated governance category — one that treats it more like a research subject record than a de-identified dataset.
What happens to your client’s data after therapy ends? This piece explores AI bias, data governance, and the hidden decisions shaping digital mental health—and offers practical tools clinicians can use to protect equity and trust in their practice.
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