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Ryan L, Weir KA, Maskell J, Bevan L, Le Brocque R. Beyond Recording the Clinical Discussion: A Qualitative Study into Patient-Led Recordings in Hospital. J Patient Exp 2023; 10:23743735231203126. [PMID: 37781068 PMCID: PMC10540596 DOI: 10.1177/23743735231203126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Patient-led recording occurs when a patient records a clinical encounter with their smart device. Understanding patient-led recording is important in ensuring a safe and patient-centered response to this behavior. This exploratory study provides insight into the patient perspective of patient-led recordings. We conducted 20 semistructured interviews with hospital and health service patients. The interview data was analyzed using thematic analysis. We identified three themes relating to patient-led recordings, including patient engagement, psychosocial, and health service. Findings suggest that health services move beyond querying the permissibility of recording and consider how to maximize the benefits of recording while reducing the risk of harm. Patients and clinicians need to be made aware of the potential broader psychosocial benefits of recording a clinical encounter during hospital admission. These results point to an urgent need for health services to develop policies and resources that support clinicians to work within a culture of recording.
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Affiliation(s)
- Laura Ryan
- Allied Health Research, Gold Coast Health, Southport, Australia
| | - Kelly A Weir
- Allied Health Research, Gold Coast Health, Southport, Australia
- Menzies Health Institute Queensland, Griffith University, Southport, Australia
| | - Jessica Maskell
- Social Work Services, Gold Coast Health, Southport, Australia
| | - Lily Bevan
- Gold Coast Health Consumer Advisory Group, Gold Coast Health, Southport, Australia
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, The University of Queensland, St Lucia, Australia
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Ryan L, Weir KA, Maskell J, Bevan L, Le Brocque R. 'What are you hiding from me?' A qualitative study exploring health consumer attitudes and experiences regarding the patient-led recording of a hospital clinical encounter. Health Expect 2022; 25:3096-3104. [PMID: 36229999 DOI: 10.1111/hex.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/11/2022] [Accepted: 09/13/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Health consumers (patients, their family, friends and carers) are frequently using their smartphones to record hospital clinical encounters. However, there is limited research which has explored the social interaction surrounding this behaviour. Understanding the consumer perspective is key to informing policy and practice. This study explored consumer attitudes and experiences regarding patient-led recordings. METHODS Semistructured interviews were undertaken with 20 hospital consumers. Participants were recruited via advertising, posters and invitation letters. Interviews were digitally recorded and transcribed. Data were analysed using thematic analysis. FINDINGS Four main themes were identified relating to participant perspectives of patient-led recordings: (1) consumers viewed clinician consent as important, although they reported different experiences of the consent process, (2) consumers indicated that a clinician refusing the recording had the potential to undermine the consumer-clinician relationship, (3) consumers were both uninformed and misinformed regarding relevant policy and legislation and (4) consumers expressed a number of expectations regarding their rights to record and of the health service in supporting this practice. CONCLUSION Consumers want to record their clinical encounters with the consent of their clinician but are unprepared to navigate consent discussions. Health services and clinicians should inform consumers who want to record about their rights and responsibilities, to support the consent process and safe recording environments. Clinician refusal to consent to a patient-led recording may not lead to increased covert recording; however, clear communication about the reasons for refusing a recording is needed to protect the consumer-clinician relationship. PATIENT OR PUBLIC CONTRIBUTION A health consumer was part of the research team and was involved in all stages of this study, including the design, data analysis and reviewing of the manuscript.
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Affiliation(s)
- Laura Ryan
- Allied Health Research, Gold Coast Health, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Kelly A Weir
- Allied Health Research, Gold Coast Health, Gold Coast University Hospital, Southport, Queensland, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Jessica Maskell
- Social Work Services, Gold Coast Health, Southport, Queensland, Australia
| | - Lily Bevan
- School of Nursing, Midwifery, and Social Work, The University of Queensland, St Lucia, Australia, Queensland
| | - Robyne Le Brocque
- Gold Coast Health Consumer Advisory Group, Gold Coast Health, Southport, Queensland, Australia
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Kim KH, Hong KJ, Shin SD, Ro YS, Song KJ, Kim TH, Park JH, Jeong J. How do people think about the implementation of speech and video recognition technology in emergency medical practice? PLoS One 2022; 17:e0275280. [PMID: 36149899 PMCID: PMC9506645 DOI: 10.1371/journal.pone.0275280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Background Recently, speech and video information recognition technology (SVRT) has developed rapidly. Introducing SVRT into the emergency medical practice process may lead to improvements in health care. The purpose of this study was to evaluate the level of acceptance of SVRT among patients, caregivers and emergency medical staff. Methods Structured questionnaires were developed for the patient or caregiver group and the emergency medical staff group. The survey was performed in one tertiary academic hospital emergency department. Questions were optimized for each specific group, and responses were provided mostly using Likert 5-scales. Additional multivariable logistic regression analyses for the whole cohort and subgroups were conducted to calculate odds ratios (OR) and confidence intervals (CI) to examine the association between individual characteristics and SVRT acceptance. Results Of 264 participants, respondents demonstrated a positive attitude and acceptance toward SVRT and artificial intelligence (AI) in future; 179 (67.8%) for video recordings, and 190 (72.0%) for speech recordings. A multivariable logistic regression model revealed that several factors were associated with acceptance of SVRT in emergency medical practice: belief in health care improvement by signal analysis technology (OR, 95% CIs: 2.48 (1.15–5.42)) and AI (OR, 95% CIs: 1.70 (0.91–3.17)), reliability of AI application in emergency medicine (OR, 95% CIs: 2.36 (1.28–4.35)) and the security of personal information (OR, 95% CIs: 1.98 (1.10–3.63)). Conclusion A high level of acceptance toward SVRT has been shown in patients or caregivers, and it also appears to be associated with positive attitudes toward new technology, AI and security of personal information.
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Affiliation(s)
- Ki Hong Kim
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- * E-mail:
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Tae Han Kim
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jeong Ho Park
- Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Joo Jeong
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Laboratory of Emergency Medical Services, Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea
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Ryan L, Weir K, Maskell J, Le Brocque R. Smartphone standoff: a qualitative study exploring clinician responses when a patient uses a smartphone to record a hospital clinical encounter. BMJ Open 2022; 12:e056214. [PMID: 35459670 PMCID: PMC9036419 DOI: 10.1136/bmjopen-2021-056214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Patients are initiating recordings of their clinical encounters using a smartphone. While this is an important, universal issue, little is known about the clinician viewpoint. Understanding clinician perspectives and behaviours is key to ensuring the protection of patient and clinician interests. This study aimed to gain a deep understanding of clinician attitudes and behaviours to patient-led recordings of hospital clinical encounters. DESIGN Semistructured interviews were conducted with 20 hospital clinicians. Participants were recruited using a combination of purposive and snowball sampling. Interviews were digitally recorded and transcribed. Transcripts were analysed using thematic analysis. SETTING This study took place at two hospitals in the metropolitan area of Gold Coast, Australia. PARTICIPANTS Participants included clinicians with varying levels of experience, or clinical managers in the roles of: medical, nursing and midwifery, and allied health staff. RESULTS The 20 participants interviewed were from a range of health disciplines and clinical areas and most had experienced a patient-led recording. Three themes emerged when exploring participant attitudes. First, that recording was a significant and controversial topic. Second, that experiences often informed clinician attitudes and many clinicians held conflicting views. Finally, a perceived loss of control was a significant stressor. A further three themes emerged relating to clinician behaviours when a patient asks to record. Decision-making involved balancing multiple factors often in pressurised situations. Shared decision-making was shaped by power dynamics and, finally, decision-making was not informed by hospital policy. CONCLUSIONS While patient-led recordings were viewed as beneficial, clinician welfare and patient safety may be at risk when a patient records a clinical encounter. Current safeguards, such as hospital policies, are not used and may not meet the needs of clinicians when decision-making is complicated by power dynamics. More research is needed to better understand how clinicians can be supported in this critical domain.
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Affiliation(s)
- Laura Ryan
- Social Work, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Kelly Weir
- Allied Health Research, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
- Griffith Health, Griffith University, Gold Coast, Queensland, Australia
| | - Jessica Maskell
- Social Work, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, The University of Queensland-Saint Lucia Campus, Saint Lucia, Queensland, Australia
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