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Caution urged on recording medical consultations

Patient-clinician interactions may yet move to being entirely digitally recorded, a UCD School of Medicine discussion heard last night (8 December).

Medics may feel more comfortable operating in this manner, given a hostile medico-legal environment, a webinar entitled ‘When scrubs and wigs collide: the medico-legal interface’ was told.

Telephone interactions with other types of service providers are now recorded, and the medical profession may move in the same direction, particularly in the post-COVID environment, attendees heard.

Transcripts

Transcripts of medical consultation may eventually become the norm, the webinar heard, in the same way that court proceedings are now digitally recorded.

Tom Hayes of the Medical Protection Society said that digital records of consultations could speed up the resolution of legal cases.

“The advice we give to our medical members is that it’s not something necessarily to be feared, and could actually help … where issues are contested,” he said.

However, audio recordings could also have a chilling effect on how freely a patient will speak, even though they could save time in establishing whether a case is defensible.

David Murphy of the Data Protection Commission said that any such recordings would involve processing and storing personal data under the GDPR.

The medico-legal world needed to approach technical solutions with extreme caution, he said.

Trust

”It has been noticed that these technologies can have a significant effect on people’s behaviours,” he said, citing  the importance of confidence, trust and open communication in the doctor-patient relationship. 

‘Observer’s paradox’ leads those who are being observed to behave differently, the webinar heard.

“From our point of view, any moves in this regard would need to be the subject of a rigorous data-protection impact assessment,” Murphy added.

It’s an important conversation, he said, particularly given the rise during the pandemic in the practice of tele-medicine.

Some patients may also illicitly record consultations, the webinar heard.

Digital formats

The recent cyber-attack on the HSE also reiterated the importance of written notes, and of not relying solely on digital formats, the webinar heard.

Departments with paper records could stay afloat, while completely computerised units faced extreme difficulty.

Barrister Doireann O’Mahony said that, in Britain, some lawyers had turned down instructions, on the basis that they were not able to navigate through indecipherable electronic records, where no paper back-up was available. 

Unless a person is actually trained in how to use them, they can be impossible to understand, she said.