TY - JOUR AU - Barr, Paul J AU - Bonasia, Kyra AU - Verma, Kanak AU - Dannenberg, Michelle D AU - Yi, Cameron AU - Andrews, Ethan AU - Palm, Marisha AU - Cavanaugh, Kerri L AU - Masel, Meredith AU - Durand, Marie-Anne PY - 2018 DA - 2018/09/12 TI -音频/视频记录美国患者个人使用的诊所访问:横断面调查JO - J医学Internet Res SP - e11308 VL - 20 IS - 9kw -录音KW -医疗保健KW -卫生系统KW -政策KW -美国KW -录像AB -背景:美国很少有诊所常规地为患者提供他们门诊就诊的音频或视频记录。虽然人们对这种做法的兴趣有所增加，但迄今为止，还没有关于美国诊所就诊记录的流行程度的数据。目的:我们的目标是:(1)确定美国患者个人使用的临床就诊录音的流行程度，(2)评估临床医生和公众对录音的态度，(3)确定是否存在政策来指导美国49个最大的卫生系统的录音实践。方法:我们于2017年7月对美国临床医生(SERMO小组)和美国公众(Qualtrics小组)的互联网小组进行了2项平行横断面调查。为了确保多样化的视角，我们设置了从8个专业捕获临床医生的配额。配额也适用于基于美国人口普查数据(性别、种族、民族和家庭使用英语以外的语言)的公共调查，以接近美国成年人口。我们通过电子邮件和电话联系了美国49个最大的卫生系统(按临床医生数量计算)，以确定是否存在指导患者个人使用临床就诊录音的政策。使用多个逻辑回归模型来确定与记录相关的因素。结果:共有456名临床医生和524名公众受访者完成了调查。 More than one-quarter of clinicians (129/456, 28.3%) reported that they had recorded a clinic visit for patients’ personal use, while 18.7% (98/524) of the public reported doing so, including 2.7% (14/524) who recorded visits without the clinician’s permission. Amongst clinicians who had not recorded a clinic visit, 49.5% (162/327) would be willing to do so in the future, while 66.0% (346/524) of the public would be willing to record in the future. Clinician specialty was associated with prior recording: specifically oncology (odds ratio [OR] 5.1, 95% CI 1.9-14.9; P=.002) and physical rehabilitation (OR 3.9, 95% CI 1.4-11.6; P=.01). Public respondents who were male (OR 2.11, 95% CI 1.26-3.61; P=.005), younger (OR 0.73 for a 10-year increase in age, 95% CI 0.60-0.89; P=.002), or spoke a language other than English at home (OR 1.99; 95% CI 1.09-3.59; P=.02) were more likely to have recorded a clinic visit. None of the large health systems we contacted reported a dedicated policy; however, 2 of the 49 health systems did report an existing policy that would cover the recording of clinic visits for patient use. The perceived benefits of recording included improved patient understanding and recall. Privacy and medicolegal concerns were raised. Conclusions: Policy guidance from health systems and further examination of the impact of recordings—positive or negative—on care delivery, clinician-related outcomes, and patients’ behavioral and health-related outcomes is urgently required. SN - 1438-8871 UR - //www.mybigtv.com/2018/9/e11308/ UR - https://doi.org/10.2196/11308 UR - http://www.ncbi.nlm.nih.gov/pubmed/30209029 DO - 10.2196/11308 ID - info:doi/10.2196/11308 ER -