‘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

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 patientled 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.

Beyond Recording the Clinical Discussion: A Qualitative Study into Patient-Led Recordings in Hospital

“…Participant behavior and perceptions of the social interaction involved in obtaining permission to record have previously been reported. 11 This paper reports on general attitudes to recording, including the uses and perceived benefits, concerns, and risks, which can understood through the following three themes: patient engagement ( Table 2 ), psychosocial ( Table 3 ), and health service ( Table 4 ).…”

“…It was decided to undertake this study within the hospital setting, as there are ample opportunities for patients to initiate a recording with multiple disciplines and across varying clinical scenarios, wards, and departments. 10 Since the legislation and policies are not well understood, 10 , 11 there is organizational vulnerability regarding patient safety, privacy, and confidentiality, with associated operational risk.…”

“…The legislation is complex and not well understood by staff or patients, and policies change across organizations. 1 , 10 , 11 In Australia, where this study was undertaken, patients can record their clinical encounters without the consent of a clinician. However, patients usually do need clinician consent to play or share this recording with others (unless a legal exception applies).…”

“…The first stage was a qualitative study which explored the experiences and attitudes of clinicians to patient-led recording. 10 , 11 This study explores the perspectives of the patient or consumer on patient-led recordings in more detail. The qualitative design was selected in order to discover processes and meaning in practice.…”

Data_Sheet_1.PDF

“…One intervention to address this issue is providing patients with consultation recordings. Several international studies have investigated this intervention, predominantly focusing on cancer patients (Tsulukidze et al, 2014), with the majority of research conducted in the United States (Tsulukidze et al, 2014;Elwyn et al, 2017;Grande et al, 2017;Barr et al, 2018Barr et al, , 2021Joshi et al, 2020;Kwon et al, 2021;Smith et al, 2022), Australia (Lipson-Smith et al, 2016;Moloczij et al, 2017;Hyatt et al, 2018Hyatt et al, , 2020Petric et al, 2021;Ryan et al, 2022), and the United Kingdom (Elwyn et al, 2015;Ivermee and Yentis, 2019;Shepherd et al, 2023). Empirical evidence supporting this intervention reveals a wide range of benefits, which help to meet information needs of patients by improving information recall (van der Meulen et al, 2008;Tsulukidze et al, 2014;Barr et al, 2018;Hyatt et al, 2018;Rieger et al, 2018;Dommershuijsen et al, 2019;Kwon et al, 2021;Petric et al, 2021;Shepherd et al, 2023), increasing feelings of being informed (Dommershuijsen et al, 2019;Hack et al, 2021), and enhancing understanding (van Bruinessen et al, 2017;Barr et al, 2018;Hyatt et al, 2018;Kwon et al, 2021;Shepherd et al, 2023).…”