Through the years, technology has continually had an effect on the doctor/patient relationship. First, there was the electronic medical record (EMR), a trend that many physicians and hospitals were slow to embrace, and are still not convinced by. Medical scribes came next ”” almost as a response to EMR ”” which created an overload of clerical responsibilities and documentation, taking physicians away from actual patient care. While this has been going on behind the scenes, more and more patients have been using digital resources to self-diagnose, sometimes as a replacement for seeing their doctor.
How will technology influence health care in 2016? The latest trends seem to be focused on recording patient/physician interactions ”” and could be coming to an exam or operating room near you.
Recording Office Visits
In this day and age when nearly everyone has a cellphone capable of recording both audio and video, it is inevitable that patients will request to record office visits, which has its advantages and disadvantages for both parties. Patients will be better able to follow their physicians”™ instructions and recommendations and can replay the recording when needed. This can be particularly valuable for memory-impaired patients or those who have just been diagnosed with a serious medical condition and may not have heard or completely understood all of the physician”™s medical jargon or advice.
In addition, being recorded could encourage physicians to focus on their bedside manner and be thorough in their interactions with patients, which can be beneficial to both parties.
Of course, having a record of a patient encounter can be a double-edged sword if litigation arises. Indeed, hospitals, leery of lawsuits, can implement strict internal policies forbidding patients from recording medical visits. There are also privacy concerns for both patients and physicians that must be addressed, since the recording could get into someone else”™s hands, thereby violating doctor-patient confidentiality. The key is for health care providers to be prepared to address a request from a patient to record a visit and develop a policy regarding video/audio in the exam room that patients are made aware of if they do in fact request to record the interaction.
Surgical black box recorders
A Toronto hospital recently started using a “black box” to record certain procedures, capturing images from a laparoscopic camera, along with hundreds of data points from around the operating room. Like the black boxes used on airplanes, the device is meant to be a teaching tool for improving patient safety and reducing risks. The recordings allow researchers to study surgical technique, communication, safety processes and room disruptions that may affect patient outcome.
Physicians and hospitals thinking of utilizing this technology may be wary out of fear that the recordings may be used against them in malpractice actions. For example, there is a danger that upon viewing the recording, a graphic detail of something going wrong may bias the jury against the defendant (even if it was a known complication or the error was not the cause of the outcome). That said, black box data could be useful to the defense if the plaintiff witnesses are suggesting that something occurred during the procedure, and the data shows definitively that it did not. In addition, patients may be concerned about their privacy being violated if the recordings get out.
In order to maximize the teaching value while minimizing the risks, hospitals considering the use of surgical black boxes should do the following:
- Emphasize that data is being collected solely for the purpose of peer review and quality improvement, so it should be protected from disclosure in legal proceedings;
- Implement a destruction policy, so that the recording, once analyzed, will be unavailable for future use/distribution;
- Identify only the surgeon but not the patient; and
- Consider storage requirements (encrypt digital information) to avoid Health Insurance Portability and Accountability Act (HIPAA) violations.
Whether you consider yourself tech-savvy or not, it is clear that technology will continue to influence the way that patients and physicians interact in 2016. To make best use of these and other technological advances, health care providers and patients must educate themselves and be prepared for these changes.
Katherine Dandy is a partner at Brown, Gruttadaro, Gaujean & Prato PLLC in White Plains. She can be reached at 914-949-5300.
