This appeared last week.
Perils of recording telehealth consultations
Authored by Cate Swannell
THE COVID-19 pandemic has necessitated rapid uptake and use of telehealth, exposing a “number of concerns potentially not previously contemplated by clinicians, patients and legislators”, according to the authors of an Ethics and law article published by the MJA.
“Recording of clinical conversations or processes may enhance patient and clinician participation, self-reference, research, education and funding,” wrote the authors, led by Dr Caitlin Farmer, a radiology registrar at Monash Health, and Dr Patrick Mahar, a dermatologist at the Skin Health Institute and the Royal Children’s Hospital Melbourne.
“In certain jurisdictions, however, clinical consultations or meetings may be lawfully recorded with or without participants’ knowledge, and may later be accessible to the patient, including for use in future legal or disciplinary proceedings, potentially stifling candid discussion,” Farmer and colleagues wrote.
“This and the challenging obligations relating to data management technicalities represent real risks for clinicians and health services.
“It is incumbent upon health care providers and lawmakers alike to consider these issues in a practical context, ensuring that telehealth is not only a useful tool but a safe and effective one.”
Farmer and colleagues wrote that before recording a consultation, clinicians needed to:
- obtain informed consent for clinician-led recordings;
- be aware of potential patient-generated recordings (both declared and undeclared); and
- meet legal, privacy and storage requirements pertaining to health information arising from a virtual consultation.
While the benefits of virtual consultations include participation of family members, the opportunity to observe the patient in their home environment, increased access, decreased risk of infection, and benefits to research, billing and coding, there are dangers for both the patient and the clinician, Farmer and colleagues wrote.
“The home setting allows for involvement of parties (seen and unseen) potentially contrary to the patient’s best interests,” they wrote.
“Pertinent examples include family violence or elder abuse contexts, where presence of offenders may jeopardise the clinical encounter and may pose direct risks to the patient in the periconsultation period and subsequently via covert audio or video footage.
“In the telehealth context, a wide audience can potentially review video footage of the consultation, as if they were there, for an indefinite period.
“This may have implications for the practicalities and duration of storage required of such material, its latent role as discoverable documentary evidence in future litigation … and in substantiation of episodic care funding.
“Clinical interactions may incorporate questions or discussions that, while appropriate sequentially, may appear inappropriate, deficient, discourteous or misleading if taken out of context or distilled to a single statement or query,” Farmer and colleagues wrote.
“Recordings, and their potential edits, could be used by patients in a maladaptive manner, engender abnormal illness behaviour, or make a participant consciously or unconsciously feel the need to perform or otherwise change clinical interactions.”
More here:
https://insightplus.mja.com.au/2021/12/perils-of-recording-telehealth-consultations/
Having read this I was forced to acknowledge that I had not thought outside the box as far as all the potential harms and risks you face in a recorded telehealth consultation. This is clearly a much more complex matter than I initially realised and the article is well worth the read to get you up to speed on all the unexpected possibilities that may lurk!
Well worth a read!
David.
1 comment:
Shock, gasp! You mean there are unintended consequences of using technology to deliver a simple solution? You mean the solution creates more problems? You mean nobody's thought it through?
But the government always sounds so certain about the benefits of using technology. They never tell us about the risks and costs, though.
It might be better if they did, but they don't seem to like to look as though they have any doubts.
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