Sharing Annotated Audio Recordings of Clinic Visits With Patients—Development of the Open Recording Automated Logging System (ORALS): Study Protocol

Abstract

BackgroundProviding patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution.ObjectiveThe aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home.MethodsWe will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth’s Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS.ResultsWe will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a US-wide network of primary care practices (www.iorahealth.com), has indicated a willingness to implement ORALS on a larger scale upon completion of this development project.ConclusionsUpon the completion of this project we will have developed a novel recording system that will be ready for large-scale testing. Our long-term goal is for ORALS to seamlessly fit into a clinic’s and patient’s daily routine, increasing levels of patient engagement and transparency of care.

Meaningful shared decision‐making: complex process demanding cognitive and emotional skills

“…A variety of decision aids has been developed and proposed to help patients understand diagnostic or treatment options . The assumption that technical information, provided in the friendly format of a decision aid, is all what is needed for people to make decisions, dismisses the value of the conversation and the essential bidirectional dimension of SDM.…”

“… Sources: Hargraves et al, Nicolai et al, Brezis et al, Tsulukidze et al, Barr et al, Almario et al, Little et al, and Krupat et al …”

“…A variety of decision aids has been developed and proposed to help patients understand diagnostic or treatment options. 55,58,[75][76][77][78][79][80] The assumption that technical information, provided in the friendly for- An additional advisable step to help clinicians might be the design of a structured tool for assessing and improving the process of SDM, as suggested in Table 1.…”

Digital clinical encounters

“…Data on the prevalence of this behaviour are being collected and already indicate that it occurs in most clinical settings 2. UK patients are not breaking the law when they record their visits; in other countries, the law might be more complex 3.…”

“…Yet a handful of clinics in the US are taking a proactive approach 2. A cancer clinic in Texas offers patient digital recorders to capture their visit information,6 and a neurological institute offers patients video recordings of their visits that are accessible on a secure website 7.…”