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Patients/Family Recording Patient Visits


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On rounds today, a patient's family member took a video recording. They pointed the camera at my badge and then my face. I haven't had any issues whatsoever with this patient or family member and to my knowledge, they don't have any issues with me or our service, but the patient has fired several nurses and has issues with some of their other providers. Could they collecting recordings for possible use in the future?

In the past, I've had patients ask if they can record me (typically on how to do a certain dressing change) or the visit to share with family later when they're available, and I almost always allow it. But on this particular instance, they didn't ask for my permission to record the visit let alone my face. I don't have anything to hide, especially in regard to my patient care, but I honestly felt violated. I'm a very private person, so I'm probably just being paranoid, but are there any personal or professional protections in place for us as providers in this kind of situation? Do I have the right to ask them to stop recording me? I left a message for the hospital's risk management to get their input.

Thoughts?

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Great post. I have been meaning to ask risk management regarding “the rules” of this but haven’t gotten around to it.

I, too, have had patients ask to record procedures (I am a provider in the ER). I think I allowed it ONCE with a curious teenager and his friends who were fascinated by the goriness of his laceration. All other times I literally just blame it on the hospital because I am fairly certain I heard once they don’t allow it. I just say “I know this procedure is cool and you can totally take before and after pics... but you can’t record the procedure itself... it’s the policy of the hospital.” When they take pics I step waaaaay out of the way to avoid being in it. I am so not comfortable with it. From a risk management standpoint and also frankly it feels violating to me to be on a video or voice recording on the phone of someone I don’t know.

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1 hour ago, ERCat said:

Great post. I have been meaning to ask risk management regarding “the rules” of this but haven’t gotten around to it.

I, too, have had patients ask to record procedures (I am a provider in the ER). I think I allowed it ONCE with a curious teenager and his friends who were fascinated by the goriness of his laceration. All other times I literally just blame it on the hospital because I am fairly certain I heard once they don’t allow it. I just say “I know this procedure is cool and you can totally take before and after pics... but you can’t record the procedure itself... it’s the policy of the hospital.” When they take pics I step waaaaay out of the way to avoid being in it. I am so not comfortable with it. From a risk management standpoint and also frankly it feels violating to me to be on a video or voice recording on the phone of someone I don’t know.

This is my approach as well, pretty much verbatim!

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If they recorded you without your knowledge and/or permission, then it might be a violation of wiretapping laws, especially if there is a reasonable expectation of privacy (which I can not imagine there wouldn't be in a patient/provider relationship).  You should consult either your facility's risk management or your own lawyers or both, because the next time you see this recording may be in court.

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I sent an inquiry to management about 2 weeks ago about this and haven't received a response. I have people frequently try to record the visit or, just as often, want to have an open phone line or Facetime during a visit. I firmly but politely shut it down. Admin doesn't want to give me guidance I assume I am free to do as I feel appropriate.

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3 hours ago, RuralER/Ortho said:

This is my approach as well, pretty much verbatim!

Same approach for myself in the UC. I'll say unfortunately per hospital policy, no video recording is allowed but you're more than welcome to get before and after pictures. I just shrug and say "administration, right?". Haven't ever run into an issue.

 

A medical podcast I listen to from time to time had an attorney on who brought up a great point in regards to patient's recording a visit. I don't remember the specifics, but my take away message was something along the lines of 'no good can come from a patient recording you'. Stopping or starting a video conversation in court can paint many different pictures of you. Something that resonated with me so I've taken the approach of absolutely no recording unless it's to demonstrate how to properly apply a brace or do a dressing change.

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Thank you for your input, everyone. I will be sure to decline next time since I agree that nothing good can come from that. 

In that moment, I felt like declining would be inflammatory to an already inflammatory patient/family (although fine to me). After discussing with a physician colleague who was also unsure on the hospital policy, what if they say no? Do I stop the encounter or just keep going? I found this resource regarding recording policies in healthcare, which are protective of physicians, staff, and other patients: https://www.healthdatamanagement.com/opinion/why-video-recording-in-healthcare-facilities-could-pose-a-hipaa-risk

I'll follow up with risk management.

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3 hours ago, thinkertdm said:

If they recorded you without your knowledge and/or permission, then it might be a violation of wiretapping laws, especially if there is a reasonable expectation of privacy (which I can not imagine there wouldn't be in a patient/provider relationship).  You should consult either your facility's risk management or your own lawyers or both, because the next time you see this recording may be in court.

Wiretapping is legal in my state if at least one party is aware. But to my understanding, that's just audio and not video. The link I posted above suggests that there may be some protections in place for providers in the healthcare setting. I will follow up with risk management.

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1 hour ago, Sed said:

what if they say no?

The only time this happened to me I told them I would be at my desk when they decided to turn off the recording and, if that wasn't satisfactory, they should leave.

I'm not going to be recorded or broadcast without my permission.

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I had a family member actually say to me, "What do you mean I can't record this?  How am I supposed to have evidence if you screw something up?"

I have a pretty low tolerance for this kind of thing.  I'll explain, politely, of course, that in any health care setting there is an inherent expectation of privacy for everyone within that facility ("Remember that patient privacy pamphlet you were given when you signed in...?").  As such, video and audio recording, as well as photography, is forbidden.  Furthermore, I do not consent to being included in any recording/photos (I live in a two party state and will explain that, too, if necessary.)  They get one chance to put it away.  If they refuse I have them escorted out. 

Sadly, I have a lot of people escorted out.

 

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7 hours ago, sas5814 said:

The only time this happened to me I told them I would be at my desk when they decided to turn off the recording and, if that wasn't satisfactory, they should leave.

I'm not going to be recorded or broadcast without my permission.

 

6 hours ago, dmdpac said:

I had a family member actually say to me, "What do you mean I can't record this?  How am I supposed to have evidence if you screw something up?"

I have a pretty low tolerance for this kind of thing.  I'll explain, politely, of course, that in any health care setting there is an inherent expectation of privacy for everyone within that facility ("Remember that patient privacy pamphlet you were given when you signed in...?").  As such, video and audio recording, as well as photography, is forbidden.  Furthermore, I do not consent to being included in any recording/photos (I live in a two party state and will explain that, too, if necessary.)  They get one chance to put it away.  If they refuse I have them escorted out. 

Sadly, I have a lot of people escorted out.

 

Thank you both for sharing your experiences. I appreciate it.

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I have had several patients ask to record office visits (family practice) and I politely decline saying it is practice policy and could potentially lead to HIPAA violation (may or may not be true, but sounds good!).  I did have one patient who I caught recording me without my permission as the visit was starting - I immediately escorted them from the property and had a letter for discharge from the practice sent that day.

Whether they violated wiretapping laws or not, if they can't respect me enough to ask permission, then there is no basis of a patient-provider relationship.

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Good topic. 

I used to let people record suturing and stuff (usually teens who thought it was cool), but then I realized that nothing good could possibly come of this. Now I tell them I dont consent to being recorded (state law is ambiguous but could be interpreted that way), and it's a HIPPA violation, which it probably is. At least video recording.

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I've met with patients with someone on the telephone listening and asking questions. I suppose they could just as easily record the conversation, but it's been my experience it's usually a good outcome. My staff are trained to document the parental consent for treatment when kiddos present with grandparents/babysitters.

 

Just returned from Kauai a few weeks ago! Gorgeous place. Highly recommend the poke (Gorilla bowl for the win) at Makei sushi. It's located inside of a Podunk grocery store. Hands down best food I ate on the island

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Update: saw the patient for a follow-up visit and asked the family member why. Their reasoning was that they wanted to keep track of everyone to keep them straight throughout the two-week admission. She showed me several dozen videos and pictures of staff. I relayed my concern about not asking my permission before videoing me and they offered to delete. Still sounded fishy... No call back from risk management yet, so I'm taking Sas' approach for right now.

On the note about Hawaii, I just came back myself. Great place to vacation.

Edited by Sed
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This is tricky and something I've dealt with a little bit as EMS and as a MA/Scribe. Video could easily be a HIPPA violation because of charts or a computer screen in the room and if it has a window, patients in the background in the hallway (not to mention something like an ER or shared room). We even needed written consent to give patients their own records and could not give them any records our providers didn't generate regardless. Often a patient would ask for the lab results (CBC/CMP/LFT/etc) that their PCP ordered before they came to see us, and we couldn't give it to them (I'm in FL and state law declares that the "owner" of the medical records is the provider who generated them; not the patient, even thought the patient has the right to obtain them, but they must do so from the "owner.") It caused a lot of headaches, but once I explained it, it became a "lawyers, am I right?" kind of thing. Furthermore, if I'm not mistaken (and I'm not a lawyer) but technically we would need written permission from the patient or guardian for anyone else to even be in the room with them (obviously we didn't do this).

I agree that although it would be nice for the well intentioned patient to have a record of their visit or consultation; no good can come of it for the facility or the provider; both in a bogus malpractice suite or a HIPPA violation from the patient in question, or another patient who was on video or whose name appeared on a computer screen in the video.

There are two options that I see, first explain what I just did and say "sorry, I won't allow it, it would be a HIPPA violation; if that is a problem I can refer you to another provider." The second is say, "Ok, but first we have to remove all medical information from the room, close the doors, and get written permission from the patient to have the recording taken and for everyone else who is in the room to be here, we must also have written permission to release medical records (which the video is) to the person taking it and everyone else in the room. In addition we need written permission from everyone else in the room to be on the recording. All of this is to comply with the federal HIPPA law whose violation can incur a fine of $50,000 to $1.5 million per occurrence. It should only take a couple of hours to get everything filled out." At which point you either dug an extremely deep hole for yourself, or they will relent and not record. To be safe I would go with option 1.

To offer something at least, we would offer them a copy of the report of the visit they could take with them (after they gave us written permission) and/or written instructions if they needed them. And then we'd take a few min to explain the report since it wouldn't make much sense to a layperson. 

If they just wanted a picture of me to remember who I was, I would allow that, but only in front of a blank wall.

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14 minutes ago, Sed said:

Good points. Thank you for your in-depth response.

I think I am now much better prepared to handle any future issues with media and patients. It's silly that we have to worry about things like this instead of just doing our job as medical providers...

The good ol days are long gone.. "lawyers am I right?"

I also just realized, according to state law in FL (which is common in many states) that if you discussed any medical information that you as a provider did not generate, the generator of the record (another provider) would also need written permission to disclose that information for the video to whoever was recording as well as everyone else in the room, since they would be in effect duplicating the record that the other provider "owns."

... maybe I should have gone to law school ?

Edited by Anachronist
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