Audio-/Videorecording Clinic Visits for Patient's Personal Use in the United States: Cross-Sectional Survey
Audio-/Videorecording Clinic Visits for Patient's Personal Use in the United States: Cross-Sectional Survey
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DOI：
10.2196/11308
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发表时间：
2018-09-01
影响因子：
7.4
通讯作者：
Durand, Marie-Anne
中科院分区：
文献类型：
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作者：
Barr, Paul J.;Bonasia, Kyra;Durand, Marie-Anne
背景：在美国，很少有诊所会定期为患者提供他们就诊的音频或视频记录。虽然对这种做法的兴趣有所增加，但迄今为止，还没有关于美国诊所就诊记录流行程度的数据。我们的目标是（1）确定美国患者个人使用的录音门诊的流行程度，（2）评估临床医生和公众对录音的态度，以及（3）确定美国49个最大的卫生系统中是否存在指导记录实践的政策。我们在2017年7月对美国临床医生（SERMO Panel）和美国公众（Qualtrics Panel）的互联网小组进行了2次平行的横断面调查。为了确保多元化的视角，我们设定了配额，以捕获来自8个专业的临床医生。根据美国人口普查数据（性别、种族、民族和在家使用的英语以外的语言），还将四分之一应用于公众调查，以近似美国成年人口。我们通过电子邮件和电话联系了美国49个最大的卫生系统（按临床医生数量），以确定是否存在指导患者个人使用的诊所就诊录音的政策。多元逻辑回归模型被用来确定与recording.Results相关的因素：在总数，456名临床医生和524名公众受访者完成了调查。超过四分之一的临床医生（129/456，28.3%）报告说，他们记录了诊所访问供患者个人使用，而18.7%（98/524）的公众报告这样做，包括2.7%（14/524）谁记录访问未经临床医生的许可。在没有记录门诊访视的临床医生中，49.5%（162/327）的人愿意在将来这样做，而66.0%（346/524）的公众愿意在将来记录。临床医生专业与既往记录相关：特别是肿瘤学（比值比[OR] 5.1，95% CI 1.9-14.9; P=.002）和身体康复（OR 3.9，95% CI 1.4-11.6; P=.01）。男性公众受访者（OR 2.11，95% CI 1.26-3.61; P=.005），年轻（年龄增加10岁的OR为0.73，95% CI 0.60-0.89; P=.002），或在家说英语以外的语言（OR 1.99; 95% CI 1.09-3.59; P=.02）更有可能记录了门诊访视。我们联系的大型卫生系统中没有一个报告了专门的政策;然而，49个卫生系统中有2个报告了现有的政策，该政策将涵盖记录诊所访问以供患者使用。记录的感知益处包括改善患者的理解和回忆。隐私和medicolegal的关注raised.Conclusions：卫生系统的政策指导和进一步检查的影响，积极或消极的记录对医疗服务，临床医生相关的结果，患者的行为和健康相关的结果是迫切需要的。
Background: Few 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.Objective: Our 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.Methods: We 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.Results: In 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.Conclusions: Policy 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.