Video Recording Patients for Direct Care Purposes: Systematic Review and Narrative Synthesis of International Empirical Studies and UK Professional Guidance (Preprint)

Abstract

UNSTRUCTURED Background: Technological advances have allowed for a variety of videorecording applications in healthcare but in practice these have largely been confined to training, research, and quality improvement. Video recordings of patients embedded as part of the electronic health record may offer advantages over text-based documentation to supplement patient assessment and clinical decision-making. However, little is about the application, acceptability, and impact of video recording patients to support their care. Objectives: Synthesise the academic literature to explore the extent to which video-based patient records are acceptable and effective in supporting direct patient care and summarise the ethico-legal considerations and guidance of professional and regulatory bodies in the United Kingdom. Methods: Five electronic databases (Medline, Embase, PsycInfo, Cochrane, HMIC) were searched from 2012 to 2022. Studies were eligible if they recruited patients ≥ 18 years and evaluated an intervention involving videorecording individual patients to support diagnosis, care, and/or treatment. All study designs and countries of publication were included. Websites of professional and regulatory bodies in the UK were searched to identify relevant guidance and recommendations. Study quality was assessed using published tools and guidance. Acceptability was evaluated using recruitment and retention rates and framework-based synthesis of patients’ and professionals’ perspectives based on Sekhon’s Theoretical Framework of Acceptability of Healthcare Interventions. To evaluate effectiveness, clinically relevant, objective measures of impact were extracted and tabulated according to study design. The framework approach was applied to synthesise reported ethico-legal considerations and recommendations of professional and regulatory bodies were extracted and tabulated. Results: Of the 14,221 abstracts screened, 27 studies met the inclusion criteria. Thirteen guidance documents were retrieved, of which seven were retained for the review. Mean recruitment rate was 68.2% (range 34.2% - 100.0%); mean retention rate was 73.3% (range 16.7% - 100.0%). Regarding acceptability, the views of patients and clinical staff were predominantly positive though some concerns were expressed about privacy, technical problems, and integrating videorecording into clinical workflows; some patients were anxious about their physical appearance. Patients and professionals perceived video-based patient records to be valuable in supporting clinical assessment, care, and treatment; in promoting patient engagement; and in enhancing communication and recall of information. Observational studies provided evidence favouring video-based records but there was no convincing evidence of effectiveness from randomised controlled trials. Reported ethico-legal considerations addressed professional and regulatory guidance including informed consent, protecting privacy, and secure storage and transmission of videos. Conclusions: Video recording patients for direct care purposes may be acceptable to patients and professionals, providing the benefits are clear, and risks are properly mitigated, but evidence of effectiveness remains uncertain. Implementation of video-based patient records must adhere to national legislation and professional guidance on consent, privacy, and data protection.