Volumes have been written, over millennia, about the Doctor-Patient relationship. Recording what goes on during such an encounter is relatively recent, and has multiple functions, including:
- To help the patient remember important information
- To pass on information to other professionals
- To protect the patient from assault
- To protect the clinician from litigation
- To satisfy 3rd parties, including relatives, regulators and the public
The format varies according to the purpose and can be a source of endless disagreement.
Wouldn’t it be better to have a complete, impartial record of everything that went on? A bit like the ‘black box’ recorders in aircraft.
As an anaesthetist, I spend considerable time during the operation manually recording vital signs, which I could fabricate if I so chose. Automatic medical device output is better, but still subject to interpretation; if the oximeter falls off the patient and shows a dangerous level of oxygenation, how is this validated and verified?
If a total record (audio/visual and device output) were available, there would be much less room for argument. This would provide a high-fidelity recording of the encounter, reviewable information for the patient and other clinicians, and perhaps most importantly, for interested third parties.
Currently, wise doctors insist on having chaperones present during sensitive consultations, etc. A ‘digital’ or ‘electronic’ chaperone would be impartial and even more reliable.
The technology is beginning to emerge to enable a digital chaperone of each and every doctor-patient encounter.