New Technology Capitalizes on Patients Recording Their Doctor Visits

JULY 05, 2018
I've been giving some thoughts to a discussion online, and from personal interactions with patients, regarding visits with their providers and care teams. The crux of the issue is whether it is appropriate for patients or caregivers to record their visits.
Now, maybe this sounds new to you, but it's been an ongoing discussion for some time. If you think about it, almost everyone now has a readily accessible recorder available: their smartphone. So, after the nurse takes your vitals, and asks some introductory questions, the patient or caregiver switches on the audio recording feature, and slides the device into their purse, pocket, or place it facedown on a chair to record the visit.
Now, the issue is whether this is appropriate or not. Patients are entitled to keep records of their appointments, but until there are open notes available for patients (which is another issue altogether), many are taking this head-on and just tracking the data shared during appointments themselves. In a way, they are now creating the black box of their health. Many providers have mixed feelings about this. Foremost, many fear that the act of being recorded may limit what they want to be stated on the record, which calls into question some form of accountability. On the other hand, many providers also seem to want to encourage this act as they see it as a useful means of facilitating clear communication with their patients.
So, what strikes me as exciting is that some companies are looking to stake a claim in this issue. Take for instance Harper, an online service that enables patients to upload a visit recording (via their app) and have it transcribed. What is interesting about this platform, is that its analytics system can identify critical terms or phrases for the patient to look up. Take for instance, if the transcription included "...your blood pressure is high, and I feel you have hypertension and could use some treatment. I am going to prescribe you lisinopril..." the platform would highlight 'hypertension' and 'lisinopril' as terms that the patient can look up for further information. 
It looks cool, with a few critiques. Their website has the platform for tagging specific sites for medical information (such as Wikipedia) that I think could be better referenced. Additionally, I would be interested if they will leverage some machine learning pathways to create summaries. The examples they showed seem to run massive amounts of text that would be easier to parse broken down into general semantics (e.g., review of systems, assessments, checklists) for the patient to jump to. It would be cool if the program could then highlight these as well globally, so if a patient wanted to read all notes or visits with a disease, they could do so—since most patients have multiple providers, and that is why they would likely be using this app.
In any event, I think other platforms like this will enter the market. The appeal, even beyond open notes from a documented EHR system, is that it notes everything said. After all, colleagues and I have made the mistake of intending to record something in the chart but forget it during clinic duties, and then that action or notation get's lost. Now, I will be curious what the reaction the medical field will be if this gets bigger. What will pharmacists do if patients use this kind of technology to record our conversations or consult in the pharmacy? How would you change your approach, or thought process knowing someone put you on the record?

Harper. Accessed July 4, 2018.

Timothy Aungst, PharmD
Timothy Aungst, PharmD
Timothy Dy Aungst, PharmD, is an associate professor of pharmacy practice at MCPHS University. He graduated from Wilkes University Nesbitt School of Pharmacy and completed a PGY-1 Pharmacy Practice Residency at St. Luke's University Hospital, and then a Clinical Geriatric Fellowship at MCPHS University. He is passionate about the rise of technology in health care and its application to pharmacy. He has published primarily on the role of mobile technology and mHealth, and made multiple national and international presentations on those topics. He blogs at, is a Co-Host of a podcast part of the Pharmacy Podcast Network, and you can find him on Twitter @TDAungst.