Audio-/Videorecording Clinic Visits for Patient’s Personal Use in the United States: Cross-Sectional Survey

Abstract

BackgroundFew clinics in the United States routinely offer patients audio or video recordings of their clinic visits. While interest in this practice has increased, to date, there are no data on the prevalence of recording clinic visits in the United States.ObjectiveOur objectives were to (1) determine the prevalence of audiorecording clinic visits for patients’ personal use in the United States, (2) assess the attitudes of clinicians and public toward recording, and (3) identify whether policies exist to guide recording practices in 49 of the largest health systems in the United States.MethodsWe administered 2 parallel cross-sectional surveys in July 2017 to the internet panels of US-based clinicians (SERMO Panel) and the US public (Qualtrics Panel). To ensure a diverse range of perspectives, we set quotas to capture clinicians from 8 specialties. Quotas were also applied to the public survey based on US census data (gender, race, ethnicity, and language other than English spoken at home) to approximate the US adult population. We contacted 49 of the largest health systems (by clinician number) in the United States by email and telephone to determine the existence, or absence, of policies to guide audiorecordings of clinic visits for patients’ personal use. Multiple logistic regression models were used to determine factors associated with recording.ResultsIn total, 456 clinicians and 524 public respondents completed the surveys. More than one-quarter of clinicians (129/456, 28.3%) reported that they had recorded a clinic visit for patients’ personal use, while 18.7% (98/524) of the public reported doing so, including 2.7% (14/524) who recorded visits without the clinician’s permission. Amongst clinicians who had not recorded a clinic visit, 49.5% (162/327) would be willing to do so in the future, while 66.0% (346/524) of the public would be willing to record in the future. Clinician specialty was associated with prior recording: specifically oncology (odds ratio [OR] 5.1, 95% CI 1.9-14.9; P=.002) and physical rehabilitation (OR 3.9, 95% CI 1.4-11.6; P=.01). Public respondents who were male (OR 2.11, 95% CI 1.26-3.61; P=.005), younger (OR 0.73 for a 10-year increase in age, 95% CI 0.60-0.89; P=.002), or spoke a language other than English at home (OR 1.99; 95% CI 1.09-3.59; P=.02) were more likely to have recorded a clinic visit. None of the large health systems we contacted reported a dedicated policy; however, 2 of the 49 health systems did report an existing policy that would cover the recording of clinic visits for patient use. The perceived benefits of recording included improved patient understanding and recall. Privacy and medicolegal concerns were raised.ConclusionsPolicy guidance from health systems and further examination of the impact of recordings—positive or negative—on care delivery, clinician-related outcomes, and patients’ behavioral and health-related outcomes is urgently required.

Heart sounds: a pilot randomised trial to determine the feasibility and acceptability of audio recordings to improve discharge communication for cardiology inpatients protocol

“…Ownership of the recording is another issue to consider, for example, the application of HIPAA to recordings made and stored by patients (a non-health entity not subject to HIPAA) and not the health system 11. A lack of policies to guide the recording and sharing of clinical visits needs to be addressed,10 and findings from our project, both quantitative and qualitative, can contribute to this conversation. If managed securely as data in an electronic medical record, recordings could transform healthcare, providing more accurate clinical records and allowing patients and families to revisit medical information that is often forgotten 23…”

“…However, it is important to also consider the privacy and confidentiality implications of recordings, for example, recording and sharing of clinically sensitive conversations and medicolegal concerns of providers. Yet to date, the use of recordings for malpractice suits has not been documented in the small number of clinics where recordings are routinely made available to patients and in at least one case in Arizona, provider participation in recordings may be protective and may result in decreased malpractice premiums 10 11. Ownership of the recording is another issue to consider, for example, the application of HIPAA to recordings made and stored by patients (a non-health entity not subject to HIPAA) and not the health system 11.…”

“…One novel strategy to improve communication of discharge instructions is emerging in the form of sharing audio recordings. Reviews indicate that sharing audio-recorded clinic visits with patients, mainly in oncology and paediatrics, has resulted in improved patient recall, satisfaction and understanding 10 11. However, the true utility of provider–patient audio recordings has yet to be determined, and its routine practice is in its infancy.…”

Consultation Recording: What Is the Added Value for Patients Aged 50 Years and Over? A Systematic Review

“…The effects of consultation recording shown by the studies included in this review might differ from the effects of consultation recording in clinical practice. Patients in the studies included in this review were all provided with a consultation tape, whilst currently patients often bring their own device to a record consultation (Barr et al, 2018). This difference in recording approach could affect the patients' reported outcomes of consultation recording because patients who take the initiative to record their consultation might be more inclined to listen to the recording and might also rate the value of recordings higher.…”

“…A commonly used tool to improve recall and understanding is consultation recording (Elwyn, Barr, & Grande, 2015). A survey in the United States has shown that more than one in four physicians ever recorded a consultation for patients' personal use and about one in five of the general public ever recorded a consultation (Barr et al, 2018;Elwyn et al, 2015). Most consultations are recorded in oncology settings (Barr et al, 2018), presumably because of the emotional nature of these consultations.…”