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BackgroundHealth care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. ObjectiveThis study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. MethodsA mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. ResultsA total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. ConclusionsData collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. Trial RegistrationAustralia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

Introduction Resourcing nurses with tools to rapidly identify cancer patients disadvantaged by complex care needs and social determinants of health provides an opportunity to address health equity. Standardised identification of people at risk of suboptimal health outcomes using digital resources can help direct support services to those with greatest need, contributing to equitable patient outcomes and system level efficiency. Objectives/Aims To describe clinician needs and preferences for the integration of a digital nursing checklist to identify complex care needs in cancer patients (The Complexity Checklist). Description/Methodology A qualitative exploratory study used semi-structured interviews and focus groups with 19 multidisciplinary participants (nurses, allied health, doctors, and researchers) within a metropolitan specialist cancer centre. Thematic content analysis, informed by an implementation science framework, was used to describe participants' requirements for Checklist integration into the electronic medical record and preferences for its use in practice. Results/Outcomes Nurses were identified as most appropriate to complete the Checklist with cancer patients on first clinical presentation or inpatient admission. All participants highlighted the importance of data collected by the Checklist, agreed it should be accessible to all members of a patient's health care team, be located somewhere highly visible in the electronic medical record and that it would be beneficial to complete with all patients. Potential barriers to Checklist integration included duplication of existing processes or patient questions and needing to incorporate the Checklist into multiple electronic workflows to account for service and discipline variability. Nurses reported the Checklist could be used in routine practice as an alternative way to record patient assessments with potential to increase efficiency by streamlining and standardising documentation. Conclusion Findings demonstrate the importance of stakeholder engagement in development of digital health resources, that there is an appetite for social determinant of health reporting and clinicians see benefit in digitally reporting complex care needs in cancer patients for clinical and research purposes. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges and complexities associated with the legal landscape surrounding health consultation recording, emphasizing the variations in consent requirements across different countries and the legal opacity throughout the entire life-cycle of each recording. It mentions despite documented benefits and technological solutions, the widespread adoption of consultation recording faces legal concerns.

Background Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients' memory of medical information. Objectives This study aimed to develop a method for eliciting and coding recall of medical information in non-English-speaking patients. Design This method, called Patient-Interpreter-Clinician coding ( PICcode), was developed in the context of a phase II trial conducted in two outpatient oncology clinics in Melbourne, Australia, and was refined iteratively through consultation with an expert panel and piloting. Between-coder differences in early versions of the coding system were resolved through discussion and consensus resulting in refinements to PICcode. Results The final version of PICcode involved transcribing, translating and coding of audio-recorded consultations and semi-structured interviews ( SSI). The SSIs were designed to elicit patients' free-recall of medical information. Every unit of medical information in the consultation was identified and categorized in a coding tree. SSIs were coded to identify the extent to which information was recalled from the consultation. Discussion The iterative changes involved in developing PICcode assisted in clarifying precise details of the process and produced a widely applicable coding system. PICcode is the most comprehensively described method of determining the amount of information that patients who use an interpreter recall from their medical consultations. PICcode can be adapted for English-speaking patients and other healthcare populations. [ABSTRACT FROM AUTHOR]