Introduction Video-recordings of patients may offer advantages over text-based documentation to supplement assessment and decision-making – particularly for older patients with complex needs. Our systematic review aimed to evaluate the application, acceptability, and impact of video-based records; here we highlight current evidence on using video-recordings to support direct care delivery for older patients. Methods Five electronic databases (Medline/Embase/PsycInfo/Cochrane/HMIC) were searched from 2012-2022. Studies involving videorecording patients aged ≥ 18 years for diagnosis, care, or treatment were identified. Study quality was assessed using published appraisal tools. Acceptability was evaluated through i) recruitment/retention rates, and ii) synthesis of patients’ and professionals’ perspectives and experiences. Sekhon’s Theoretical Framework of Acceptability (TFA), consisting of seven constructs (affective attitude/burden/ethicality/intervention coherence/opportunity costs/self-efficacy), underpinned the synthesis. Results Of 14,221 citations, 27 studies (mainly low-quality) met inclusion criteria. 10/27 studies recruited older patients including those with Parkinson’s Disease (PD), dementia, stroke, end-of-life care, average age was 69. Video-recording was used in diagnosis, management/monitoring, and rehabilitation of older patients. Mean recruitment rate was 58.8% (34.2%-73.7%): mean retention rate was 81.3% (73.4%-100%). Reasons for non-participation/withdrawal related to the video-recording intervention itself (privacy concerns/poor video quality) and other factors (patients lost to follow-up). Framework synthesis generated 17 sub-themes linked to the seven TFA constructs. Attitudes to video-based records were largely positive. Video-recordings were perceived to be helpful in facilitating diagnosis/treatment/care for patients with movement disorders (PD; high-risk fallers), including in dementia populations. Digital literacy, illness severity and cognitive impairment influenced patients’ capacity to consent to video-recording. Healthcare professionals were concerned about technical challenges but burden was minimised through using portable devices (e.g. iPad) for video capture. Conclusion Video-based records may be acceptable to older patients and professionals, providing valid consent is obtained and the potential benefits are recognised. Further research is needed to evaluate the acceptability, feasibility, and effectiveness.

Background Video recordings of patients may offer advantages to supplement patient assessment and clinical decision-making. However, little is known about the practice of video recording patients for direct care purposes. Objective We aimed to synthesize empirical studies published internationally to explore the extent to which video recording patients is acceptable and effective in supporting direct care and, for the United Kingdom, to summarize the relevant guidance of professional and regulatory bodies. Methods Five electronic databases (MEDLINE, Embase, APA PsycINFO, CENTRAL, and HMIC) were searched from 2012 to 2022. Eligible studies evaluated an intervention involving video recording of adult patients (≥18 years) to support diagnosis, care, or treatment. All study designs and countries of publication were included. Websites of UK professional and regulatory bodies were searched to identify relevant guidance. The acceptability of video recording patients was evaluated using study recruitment and retention rates and a framework synthesis of patients’ and clinical staff’s perspectives based on the Theoretical Framework of Acceptability by Sekhon. Clinically relevant measures of impact were extracted and tabulated according to the study design. The framework approach was used to synthesize the 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. Overall, 13 guidance documents were retrieved, of which 7 were retained for review. The views of patients and clinical staff (16 studies) were predominantly positive, although concerns were expressed about privacy, technical considerations, and integrating video recording into clinical workflows; some patients were anxious about their physical appearance. The mean recruitment rate was 68.2% (SD 22.5%; range 34.2%-100%; 12 studies), and the mean retention rate was 73.3% (SD 28.6%; range 16.7%-100%; 17 studies). Regarding effectiveness (10 studies), patients and clinical staff considered video recordings to be valuable in supporting assessment, care, and treatment; in promoting patient engagement; and in enhancing communication and recall of information. Observational studies (n=5) favored video recording, but randomized controlled trials (n=5) did not demonstrate that video recording was superior to the controls. UK guidelines are consistent in their recommendations around consent, privacy, and storage of recordings but lack detailed guidance on how to operationalize these recommendations in clinical practice. Conclusions Video recording patients for direct care purposes appears to be acceptable, despite concerns about privacy, technical considerations, and how to incorporate recording into clinical workflows. Methodological quality prevents firm conclusions from being drawn; therefore, pragmatic trials (particularly in older adult care and the movement disorders field) should evaluate the impact of video recording on diagnosis, treatment monitoring, patient-clinician communication, and patient safety. Professional and regulatory documents should signpost to practical guidance on the implementation of video recording in routine practice. Trial Registration PROSPERO CRD42022331825: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331825

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.