healthcare technology

In the 10 years since the launch of the first Apple iPhone in 2007, mobile devices have become integral to many people’s daily life.1 It is not surprising then that some patients want to bring their smartphones into their physicians’ offices to record some or all of their clinical healthcare encounter.

These recordings (audio or video) may benefit patients, giving them improved clarity about their health and a greater sense of engagement, possibly leading to better adherence to their care plan. However, any recording in a physician’s office also has the potential to raise issues, such as the privacy of other patients and staff, the impact on the doctor-patient relationship, and the incorporation into the medical record.

To leverage the possible benefits of recordings and counter any possible problems, physicians need to be prepared. They should become aware of their privacy obligations and consider whether to adopt a policy on recordings in their premises. Any policy should address potential problems that are specific to a recording’s location—that is, the policy must address recordings made in public areas, such as waiting rooms, and recordings made in private areas, such as an examination room.

What can physicians do about recordings in their offices?

Physicians should prepare for patient recordings and consider adopting a policy on the use of smartphones and other recording devices in their offices.

Any policy should distinguish between what is allowed in public spaces and in private areas. At a minimum, physicians should consider whether it is necessary to prohibit patients from taking photos and making video and audio recordings in the waiting room or other public areas to protect the privacy of patients and staff members.

Impact on the doctor-patient relationship

A patient may have valid reasons for wanting to record a clinical encounter in a private area such as an examination room. They may want to have an accurate record of the physician’s advice, or to share the information with a family member. However, the recording of a clinical encounter by a patient without the physician’s knowledge can be perceived as reflecting a lack of confidence in the relationship on the part of the patient.

As well, misunderstandings related to recordings can lead to regulatory authority (College) complaints.

Google Translate has only 57.7% accuracy when used for medical phrase translations and should not be trusted for important medical communications.

However, it still remains the most easily available and free initial mode of communication between a doctor and patient when language is a barrier.

Although caution is needed when life saving or legal communications are necessary, it can be a useful adjunct to human translation services when these are not available.

Read the research paper below which formed the above conclusion.

Communication is the cornerstone of medicine, without which we cannot interact with our patients. The General Medical Council’s Good Medical Practice states that “Doctors must listen to patients, take account of their views, and respond honestly to their questions. However, we still often interact with patients who do not speak the local language.

In the United Kingdom most hospitals have access to translation services, but they are expensive and often cumbersome. A complex and nuanced medical, ethical, and treatment discussion with patients whose knowledge of the local language is inadequate remains challenging. Indeed, even in a native language there is an element of translation from medical to lay terminology.

We recently treated a very sick child in our paediatric intensive care unit. The parents did not speak English, and there were no human translators available. Reluctantly we resorted to a web based translation tool. We were uncertain whether Google Translate was accurately translating our complex medical phrases. Fortunately our patient recovered, and a human translator later reassured us that we had conveyed information accurately.

We aimed to evaluate the accuracy and usefulness of Google Translate in translating common English medical statements.

Ten medical phrases were evaluated in 26 languages (8 Western European, 5 Eastern European, 11 Asian, and 2 African), giving 260 translated phrases. Of the total translations, 150 (57.7%) were correct while 110 (42.3%) were wrong. African languages scored lowest (45% correct), followed by Asian languages (46%), Eastern European next with 62%, and Western European languages were most accurate at 74%. The medical phrase that was best translated across all languages was “Your husband has the opportunity to donate his organs” (88.5%), while “Your child has been fitting” was translated accurately in only 7.7% (table⇓). Swahili scored lowest with only 10% correct, while Portuguese scored highest at 90%.