Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, July 01, 2022

There Is A Lot More To Discuss And Consider When Planning To Record Clinical Consultations Than Is Instantly Obvious.

This appeared last week:

How to make it ok to record medical appointments

Clear processes are needed for recording medical consultations. New research aims to help patients and providers to record openly

By Dr Megan Prictor, University of Melbourne and Amelia Hyatt, Peter McCallum Cancer Centre and University of Melbourne 

30 May, 2022


Seeing a health professional is an essential part of the healthcare journey, whether it is in person or through the now common telehealth service. During these relatively short interactions, a lot of important, sometimes life-changing information is shared.

However, research has shown that people forget most of what they are told in healthcare appointments. This means that they might not understand their illness very well or might find it difficult to remember important health or treatment information like what dose of medication to take or how to prepare for surgery.

This is especially true when people are being told upsetting news, including receiving a diagnosis of cancer or another serious condition, or must undergo significant treatment like a major operation. Not having a clear memory of what was discussed can limit people’s understanding and ability to participate in important decisions about their treatment and care.

Enhancing trust and care

From over thirty years of research, we know that people find it helpful to be able to later listen to an audio recording of their health consultation. Importantly, recordings work well to improve people’s recall and understanding of the information they were given by the health professional.

Being able to play a recording of a consultation back, for instance, to close family members, or even to another doctor such as the patient’s GP, also means that those around the patient can understand, help and support them better.

Health professionals also value and support the use of consultation recordings for the benefits it can provide to their patients. Recording has been found to enhance the patient’s trust in the health professional and makes them feel more supported and more satisfied with their care.

To understand more about people’s preferences, specifically how and why people record their medical appointments, our team of law and health researchers has launched a new short and anonymous survey.

The results will help explain why some people are making recordings when they see their doctor or another health professional, who they want to then share these recordings with, and how. Our goal is to gather information on this often-hidden practice for the first time in Australia, to help inform the design of new policies and recording technologies.

New ways to share health information

Previously, studies of consultation recording used cassette tapes and clunky technology. Now, smartphone voice recorders make it easy for anyone to record their healthcare consultation, and some health professionals encourage their patients to do that for the reasons above.

There are also new apps designed to enable patients to record their appointments, many of which include extra functions including automatically generating written transcriptions of the consultations or highlighting key medical terms and linking to reputable sources of health information.

At the Peter MacCallum Cancer Centre they are developing the SecondEars app to make it easier for patients to record their visits. It uploads a copy of the recording to the patient’s electronic medical record before the patient can listen back to it.

It is also known, from anecdotal evidence and through research conducted in the United Kingdom and the US, that people often make recordings of their consultations without telling the health professional. For instance, 26 per cent of people completing one survey in the UK reported that they had recorded a visit with a health professional covertly, or they knew someone who had.

Designing new policies and technology

While covert recording might still provide the benefits to patients we mentioned earlier, it could be seen as unfair as it risks undermining the doctor-patient relationship and makes some health professionals concerned that patients might be wanting to ‘trip them up’.

Although research overseas has explored how often people have recorded their consultations (both covertly and openly) and whether they want to in the future, the picture in Australia is much less clear as no one has collected this information before.

This means that efforts made by health services such as the Peter Mac, or even by individual health professionals to promote consultation recording, are ‘flying blind’. They don’t have the information they need to help design new recording technologies and the policy framework to support them.

Our new survey aims to fill this gap by seeking as many people as possible to complete it and share their current practices and preferences about healthcare recording.

But as well as technological considerations, there are lots of legal and ethical questions about recording consultations. Concerns about these, and about the rights of health professionals and patients to make and share recordings, might make people hesitant.

This has led us to undertake other research and wide-ranging conversations across the spheres of law and regulation, clinical practice and with the involvement of patients.

Ethical and legal support for recording

Our work has looked at what doctors and patients think about a consultation recording app and what Australian law allows and requires – especially in terms of consent to make a recording and to play a recording to others.

Our legal research found that relevant law in Australia is complex, with significant differences between jurisdictions, making it all the more important that new technologies to enable consultation recording are explicit about the terms and conditions of the recording and its later use.

Our goal is for this engagement and research to bring changes in policy and practice so that more patients and health professionals can receive the known benefits of consultation recording. But we need to do this in an ethical way and address the needs and concerns of everyone involved.

Dr Megan Prictor, University of Melbourne and Amelia Hyatt, Peter McCallum Cancer Centre and University of Melbourne.

Here is the link:

https://pursuit.unimelb.edu.au/articles/how-to-make-it-ok-to-record-medical-appointments

This is a really useful discussion and makes the point well that when used sensibly having a recording of what the doctor said can really make it easier for the patient to understand what is meant – on re-listening – in the calm after a consultation. Of course sharing with relatives and friends can also help.

Telehealth can make a recording possibly even more useful.

It is also clear that there needs to be informed consent for what is being done from all parties and that covert recording should be discouraged.

With various varieties of telehealth – which can easily cross State borders – in an ideal world we would have a national framework of laws to regulate what is done and set appropriate limits on sharing and use of such recording. Again fairness needs to be a major driver as well as maximizing what the patient can get out of the process.

We also need to be assured that clinicians can be comfortable about being recorded by making exploitation or abuse of recordings illegal.

I wonder what stories are out there about the good and bad of such recording?

David.

9 comments:

Anonymous said...

And where might be a good place to put such recordings? In MyHR? Has anyone ever thought of such a thing? Has anyone analysed the consequences? The effort to extract the important bits?

Of course not. That's because MyHR is a dumb data repository; an archaic record keeping practice.

Consultation recordings are about information.

Anonymous said...

ICYMI, on Twitter:

1 July
Amanda Cattermole PSM
@A_Cattermole
Today @AuDigitalHealth celebrates six years of Agency operations, helping enable Australia’s health agenda through digital innovation. We’re looking forward to delivering more in 2022-23 as the Agency continues to connect Australians to a healthier future.

https://twitter.com/A_Cattermole/status/1542711879818448897

ADHA is living in a parallel universe where more than $2billion just doesn't matter.

It's interesting to see how many people agree:
2 retweets and 3 likes.

Maybe they are in a vacuum rather than a parallel universe.

Anonymous said...

That tweet does to read well. The ADHA must be going through big changes in the communications team - the only area they seemed tight on - until recently

Sarah Conner said...

Agree that tweet probably does more harm than good.

Remember everyone if you care about freedoms please avoid buying US products and services.

Anonymous said...

"...helping enable Australia’s health agenda through digital innovation"

Maybe the ADHA should have a word with the Department of Health about "digital innovation".

Maybe the ADHA should volunteer to abolish themselves and the MyHR so the money could be spent actually helping people.

Vulnerable Australians ‘filled with dread’ over telehealth cuts
https://www.theguardian.com/australia-news/2022/jul/02/vulnerable-australians-filled-with-dread-over-telehealth-cuts

"Living through Covid-19 with inflammatory arthritis, telehealth has been the only way for Eliza Sorensen to safely access her routine medical appointments.

Sorensen is considered severely immunocompromised due to the medication she takes to control her chronic disease. She also lives with asthma.

Sorensen says the government’s decision not to extend pandemic-related telehealth services will be “devastating” for her and people in similar situations."

Anonymous said...

8:07PM said “ Remember everyone if you care about freedoms please avoid buying US products and services.”

Not something I ever dreamed of seeing yet alone agreeing with. Sad state of affairs, but demonstrates how easily the pendulum can swing from light to darkness.

Paul Dayle said...

July 02, 2022 10:37 PM - hardly an expensive service for us tax payers and clearly meets a need of fellow citizens, but yet that gets pulled while the low-value high-risk agencies like ADHA, CHF, Healthdirect, DH CRC, and so on get huge amounts of funding.

The new Government has a lot to unwind and repair.

Andrew McIntyre said...

This would be a gross invasion of the doctor patient relationship, making discussions available to the government, which would restrict what is said to the government narrative to a much greater extent than is already occurring. Also patients tell you things that they do not want documented, many people have dark secrets that influence their health and they would be reluctant to disclose if it was recorded. Its quite totalitarian when you look behind the superficial rhetoric!

Bernard Robertson-Dunn said...

@July 10, 2022 9:00 AM

Well said Andrew. Yet another example of not thinking things through - something academics and the Federal government (and IT vendors) are equally guilty of.

In fact, they are all unable to think things through - they are too far removed from the reality of healthcare delivery.