scholarly journals What to do when a patient wants to record a patient-physician interaction in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (3) ◽  
pp. 471-475 ◽  
Author(s):  
Brodie Nolan ◽  
Alun Ackery ◽  
Bryan Au
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Patient Privacy ◽  
Video Recordings ◽  
Technological Advances ◽  
Quality Video ◽  
Video And Audio ◽  
The One ◽  
High Quality Video

ABSTRACTRecent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, patient privacy is highly regulated by provincial legislation, although patients themselves have little in the way of laws or regulations to observe. Patients taking video recordings of their own medical care does not currently fall under any of the provincial privacy laws. With no such governance for the general public, patients generally have greater freedom to record a patient-physician interaction. Unfortunately, there are no official policies from the provincial physician colleges regarding how best to proceed in these circumstances. Therefore, the onus is on individual hospitals and emergency departments (EDs) to develop their own policy on video recordings. A policy should ideally cover possible recording devices, locations, staff involved, and mandate that a written consent form be included with the patient’s chart. While every request should be considered individually, physicians should generally not feel compelled to agree to the patient recording the clinical encounter. Patients are legally allowed to record a patient-physician interaction without consent of their physician, because the patient can provide the “one-party consent” for the conversation to be recorded. Physicians should accept the possibility that they are being recorded at all times and should strive to communicate as clearly and effectively as possible. Physicians should strive to provide the same level of care that they would even if they were not being recorded, and not let it interfere with their clinical decision-making.

scholarly journals P096: Hospitalselfie: a review of implications and recommendations on patients making video recordings in hospital

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S110-S110
Author(s):  
B. Nolan ◽  
A. Ackery ◽  
B. Au
Keyword(s):  
Video Recording ◽  
Criminal Code ◽  
Physician Patient Relationship ◽  
Privacy Law ◽  
Video Recordings ◽  
Video Record ◽  
Technological Advances ◽  
Quality Video ◽  
Smartphone Use ◽  
Video And Audio

Introduction: Smartphones are everywhere. Recent technological advances allow for instantaneous high quality video and audio recordings with the touch of a button. In Canada, physician smartphone use is highly regulated by provincial legislature and multiple policies have been published from provincial physician colleges and the Canadian Medical Protective Association (CMPA). Patients on the other hand have no such laws to observe. We set out to look at what legislation and policies exist to provide guidance to physicians in two potential scenarios: when a patient requests to record a patient-physician interaction and if a patient surreptitiously records a patient-physician interaction without consent of the physician. Methods: A literature review searching for articles on patient video recordings and patient smartphone use was completed on both Medline and PubMed. Further review of each provincial privacy act and communication with each provincial privacy office was performed. Consultation with each provincial physician college and the CMPA was also done to identify any policies or recommendations to guide physicians. Results: Patients making video recordings do not fall under any provincial privacy law and there are no existing policies from any provincial physician college or the CMPA to provide guidance. Therefore, physicians must rely on their own institution’s policy regarding patient video recording in the health care setting. Be familiar with your institution’s policy. If your institution does not have a policy, create one with the input of appropriate stakeholders. Patients may surreptitiously video record medical interactions without physician consent. Although this may not be permitted under an individual institution’s policy, it is not illegal under the Criminal Code. Thus, it is important to behave in a professional manner at all times and assume you may be recorded at any time. Conclusion: The majority of patients’ recordings will be done without litigious intentions, but rather with the goal of understanding more about their own health and medical care. Unfortunately there are those who will undermine the physician-patient relationship. Physicians cannot allow this to cause distrust in future relationships, nor should it force physicians to practice more defensive medicine. Physicians must continue to practice the art of medicine and accept that “performance” is a part of the job.

Technological advances to aid clinical decision making

Equine Health ◽  
2014 ◽  
Vol 2014 (16) ◽  
pp. 34-37
Author(s):  
Thilo Pfau ◽  
Andrew Fiske-Jackson ◽  
Susanne Troster
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Technological Advances

scholarly journals The revolution of personalized psychiatry: will technology make it happen sooner?

2017 ◽  
Vol 48 (5) ◽  
pp. 705-713 ◽  
Author(s):  
G. Perna ◽  
M. Grassi ◽  
D. Caldirola ◽  
C. B. Nemeroff
Keyword(s):  
Clinical Decision Making ◽  
Clinical Decision ◽  
Machine Learning Techniques ◽  
Proof Of Concept ◽  
Time Data ◽  
New Approach ◽  
Technological Advances ◽  
Learning Techniques ◽  
Personalized Psychiatry ◽  
Smart Wearable

Personalized medicine (PM) aims to establish a new approach in clinical decision-making, based upon a patient's individual profile in order to tailor treatment to each patient's characteristics. Although this has become a focus of the discussion also in the psychiatric field, with evidence of its high potential coming from several proof-of-concept studies, nearly no tools have been developed by now that are ready to be applied in clinical practice. In this paper, we discuss recent technological advances that can make a shift toward a clinical application of the PM paradigm. We focus specifically on those technologies that allow both the collection of massive as much as real-time data, i.e., electronic medical records and smart wearable devices, and to achieve relevant predictions using these data, i.e. the application of machine learning techniques.

scholarly journals Circulating Tumor Cell Analysis: Technical and Statistical Considerations for Application to the Clinic

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Alison L. Allan ◽  
Michael Keeney
Keyword(s):  
Metastatic Disease ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Circulating Tumor Cell ◽  
Cell Analysis ◽  
Important Indicator ◽  
Robust Detection ◽  
Technological Advances ◽  
Clinical Detection

Solid cancers are a leading cause of death worldwide, primarily due to the failure of effective clinical detection and treatment of metastatic disease in distant sites. There is growing evidence that the presence of circulating tumor cells (CTCs) in the blood of cancer patients may be an important indicator of the potential for metastatic disease and poor prognosis. Technological advances have now facilitated the enumeration and characterization of CTCs using methods such as PCR, flow cytometry, image-based immunologic approaches, immunomagnetic techniques, and microchip technology. However, the rare nature of these cells requires that very sensitive and robust detection/enumeration methods be developed and validated in order to implement CTC analysis for widespread use in the clinic. This review will focus on the important technical and statistical considerations that must be taken into account when designing and implementing CTC assays, as well as the subsequent interpretation of these results for the purposes of clinical decision making.

Living translation in US Chinese medicine

2012 ◽  
Vol 41 (3) ◽  
pp. 343-363 ◽  
Author(s):  
Sonya E. Pritzker
Keyword(s):  
Chinese Medicine ◽  
Language Ideologies ◽  
Clinical Decision Making ◽  
Classroom Interaction ◽  
Clinical Decision ◽  
Social Positioning ◽  
Southern California School ◽  
Audio Data ◽  
Video And Audio ◽  
Target Languages

AbstractThis article demonstrates the ongoing, culturally situated and co-constructed nature of the translation of Chinese medicine from Chinese into English. Building upon scholarship in anthropology, sociolinguistics, and translation studies, this article contributes to the building of an anthropologically grounded theory of translation as an ongoing lived event, with implications far beyond the simple transfer of meaning from “source” to “target” languages. Through the examination of video and audio data collected over two years, I show how participants in classroom interactions at a southern California school of Chinese medicine not only interactively accomplish the work of translating specific Chinese terms, but also accomplish a great deal socially with such translation activity. Participants are thus shown to use translation as a platform for social positioning as well as a tool for socializing interlocutors into various notions of evidence and ideologies of language, both of which have implications for clinical decision-making in practice. (Translation, language ideologies, classroom interaction, Chinese medicine)*

scholarly journals The Tumor Profiler Study: Integrated, multi-omic, functional tumor profiling for clinical decision support

2020 ◽  
Author(s):  
Anja Irmisch ◽  
Ximena Bonilla ◽  
Stéphane Chevrier ◽  
Kjong-Van Lehmann ◽  
Franziska Singer ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision Making ◽  
Biomarker Discovery ◽  
Digital Pathology ◽  
Predictive Biomarker ◽  
Clinical Decision ◽  
Technological Advances ◽  
Comprehensive Information ◽  
Spatial Composition

AbstractRecent technological advances allow profiling of tumor samples to an unparalleled level with respect to molecular and spatial composition as well as treatment response. We describe a prospective, observational clinical study performed within the Tumor Profiler (TuPro) Consortium that aims to show the extent to which such comprehensive information leads to advanced mechanistic insights of a patient’s tumor, enables prognostic and predictive biomarker discovery, and has the potential to support clinical decision making. For this study of melanoma, ovarian carcinoma, and acute myeloid leukemia tumors, in addition to the emerging standard diagnostic approaches of targeted NGS panel sequencing and digital pathology, we perform extensive characterization using the following exploratory technologies: single-cell genomics and transcriptomics, proteotyping, CyTOF, imaging CyTOF, pharmacoscopy, and 4i drug response profiling (4i DRP). In this work, we outline the aims of the TuPro study and present preliminary results on the feasibility of using these technologies in clinical practice showcasing the power of an integrative multi-modal and functional approach for understanding a tumor’s underlying biology and for clinical decision support.

scholarly journals The TCI Clinical Encounter Program for PhD Students in Cancer Biology: a Feasibility Pilot

2021 ◽  
Author(s):  
Alexander M. Real ◽  
Jenny J. Lin ◽  
Janice L. Gabrilove
Keyword(s):  
Cancer Patients ◽  
Clinical Experience ◽  
Cancer Biology ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Biomedical Science ◽  
Pilot Program ◽  
Biomedical Sciences ◽  
Advanced Degrees

Abstract Clinical rotations are often not included in graduate-level cancer biology curricula; however, basic insight into clinical oncology is often crucial for developing translational research that addresses unmet needs with the potential to benefit cancer patients. We describe a needs assessment, design, implementation, and descriptive evaluation of an oncology-specific pilot clinical encounter program developed for PhD students in the Cancer Biology Training Area (CAB) in the Graduate School of Biomedical Sciences (GSBS) and Tisch Cancer Institute (TCI) at the Icahn School of Medicine at Mount Sinai (ISMMS). Prior to the development of this pilot program, CAB students, in years 2–5 + , were surveyed to determine their interest in a structured clinical experience. Seventeen out of thirty-one students responded (55%) to the survey. Of those seventeen respondents, fifteen (88.2%) expressed that exposure to cancer patients in the clinical setting would be useful for their pre-doctoral biomedical science and cancer biology training and indicated an interest in participating in the clinical encounter program. Based on these responses, a three-session clinical encounter pilot program was designed. Two separate cohorts of 5 students participated in this pilot program. During a formal debrief, following the clinical experience, students commented on the resilience of patients and the importance of research on clinical decision making, and reported that they found the experience motivational. Five out of 10 students responded (50%) to a post-program assessment survey; all five respondents answered that they would recommend the clinical encounter program to their peers. While limited in size and scope, this pilot TCI Clinical Encounter Program proved feasible and has the potential to enrich and inform the experience of PhD students pursing advanced degrees in a cancer biology.

Case Studies: Stahl's Essential Psychopharmacology

2011 ◽  
Author(s):  
Stephen M. Stahl ◽  
Nancy Muntner
Keyword(s):  
Clinical Decision Making ◽  
Real Life ◽  
Clinical Decision ◽  
Clinical Encounter ◽  
Waiting Room ◽  
Clinical Scenarios ◽  
The Everyday ◽  
Representative Selection ◽  
User Friendly ◽  
Selection Of

Designed with the distinctive, user-friendly presentation Dr Stahl's audience know and love, this new stream of Stahl books capitalize on Dr Stahl's greatest strength - the ability to address complex issues in an understandable way and with direct relevance to the everyday experience of clinicians. The book describes a wide-ranging and representative selection of clinical scenarios, making use of icons, questions/answers and tips. It follows these cases through the complete clinical encounter, from start to resolution, acknowledging all the complications, issues, decisions, twists and turns along the way. The book is about living through the treatments that work, the treatments that fail, and the mistakes made along the journey. This is psychiatry in real life – these are the patients from your waiting room – this book will reassure, inform and guide better clinical decision making.

scholarly journals New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences

2021 ◽  
Vol 15 ◽  
Author(s):  
Bastien Lechat ◽  
Hannah Scott ◽  
Ganesh Naik ◽  
Kristy Hansen ◽  
Duc Phuc Nguyen ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Sleep Disorders ◽  
Sleep Disorder ◽  
Feature Detection ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Sleep Disruption ◽  
Technological Advances ◽  
Continuous Eeg ◽  
Circadian Rhythm Sleep Disorders

Current approaches to quantify and diagnose sleep disorders and circadian rhythm disruption are imprecise, laborious, and often do not relate well to key clinical and health outcomes. Newer emerging approaches that aim to overcome the practical and technical constraints of current sleep metrics have considerable potential to better explain sleep disorder pathophysiology and thus to more precisely align diagnostic, treatment and management approaches to underlying pathology. These include more fine-grained and continuous EEG signal feature detection and novel oxygenation metrics to better encapsulate hypoxia duration, frequency, and magnitude readily possible via more advanced data acquisition and scoring algorithm approaches. Recent technological advances may also soon facilitate simple assessment of circadian rhythm physiology at home to enable sleep disorder diagnostics even for “non-circadian rhythm” sleep disorders, such as chronic insomnia and sleep apnea, which in many cases also include a circadian disruption component. Bringing these novel approaches into the clinic and the home settings should be a priority for the field. Modern sleep tracking technology can also further facilitate the transition of sleep diagnostics from the laboratory to the home, where environmental factors such as noise and light could usefully inform clinical decision-making. The “endpoint” of these new and emerging assessments will be better targeted therapies that directly address underlying sleep disorder pathophysiology via an individualized, precision medicine approach. This review outlines the current state-of-the-art in sleep and circadian monitoring and diagnostics and covers several new and emerging approaches to better define sleep disruption and its consequences.

Untapped Potential of Observational Research to Inform Clinical Decision Making: American Society of Clinical Oncology Research Statement

2017 ◽  
Vol 35 (16) ◽  
pp. 1845-1854 ◽  
Author(s):  
Kala Visvanathan ◽  
Laura A. Levit ◽  
Derek Raghavan ◽  
Clifford A. Hudis ◽  
Sandra Wong ◽  
...  
Keyword(s):  
Decision Making ◽  
Observational Studies ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Observational Research ◽  
Patient Privacy ◽  
Oncology Research ◽  
Electronic Health ◽  
American Society ◽  
Electronic Health Information

ASCO believes that high-quality observational studies can advance evidence-based practice for cancer care and are complementary to randomized controlled trials (RCTs). Observational studies can generate hypotheses by evaluating novel exposures or biomarkers and by revealing patterns of care and relationships that might not otherwise be discovered. Researchers can then test these hypotheses in RCTs. Observational studies can also answer or inform questions that either have not been or cannot be answered by RCTs. In addition, observational studies can be used for postmarketing surveillance of new cancer treatments, particularly in vulnerable populations. The incorporation of observational research as part of clinical decision making is consistent with the position of many leading institutions. ASCO identified five overarching recommendations to enhance the role of observational research in clinical decision making: (1) improve the quality of electronic health data available for research, (2) improve interoperability and the exchange of electronic health information, (3) ensure the use of rigorous observational research methodologies, (4) promote transparent reporting of observational research studies, and (5) protect patient privacy.

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