Could you speak more to the potential role of these recordings in research?


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We can form a much more complete understanding of the human condition if we can capture subjective data in addition to quantitative data. For example, mental health conditions and subjective issues such as pain can be understood and ultimately helped by an audio recording of how the patient describes his or her experience. With enough recordings we can start to understand how the way we express our feelings may impact what test may lead to an improvement of our health.  I hope it will also help us clinicians more effectively communicate to our patients some of the more complex aspects of clinical decision making.

For me as a PCP, patients with certain mental health conditions can be very challenging. If you tell someone that their blood pressure it out of range and such-and-such medication is effective for controlling it, and the individual is healthy when it comes to life management, the situation is relatively simple. I call in a prescription for that medication, it works or it does not, in which case it might be titrated until it works, or the person is switched to a different agent.

But for some people with mental health conditions, prescribing, monitoring, and remaining on top of adherence can be more difficult, and benchmarks of improvement are harder to quantify. Much more rests upon the patient’s subjective experience. The journey towards controlling blood pressure can have many steps and with our current reporting process we fail to recognize small steps towards this valuable goal. So recordings can be an extremely helpful way of capturing the person’s experience and also encouraging the patient to continue the regimen.

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How do your patients feel about being recorded?

I leave it up to the individual patient whether or not to be recorded. Most of my patients are comfortable. I would estimate that perhaps 5% or less refuse. For some patients, becoming comfortable can be a large shift, but the history of medicine is filled with advances that challenge the prevailing culture. For example dissections were prohibited, leading to extremely restricted anatomical knowledge. That changed as people gradually overcame the fear, and then an entirely new dataset was available that went on to change the concept of the physiology in the human body.

Certainly, we shouldn’t just rush in like unruly children, but if we don’t move forward, we won’t grow through this change.

What types of recordings do you create, and how are they used?

When I am recording, I have a large screen in each room. I am most interested in problems and task management in chronic complex care. Everything is broken down into problems, and tasks to manage those problems. When patients and caregivers log in, we have messaging that follows those problems or tasks. If the patient is in the system the screen will clearly indicate that the visit is being recorded. There is a pause button that can be pushed in case they don’t want to have something recorded.

This article originally appeared on MPR