The growing phenomenon of patients covertly recording clinical encounters is generating strong reactions, both positive and negative, according to a recent analysis of articles and online posts about the issue published between 2006 and 2013. Noting that the phenomenon of covert recording is a new behavior made possible with the availability of smartphones with digital recording, the analysis identifies four themes from the articles and posts contributed by a wide range of individuals, including physicians, patients, lawyers, and insurers. The analysis was published May 1, 2015, in the online journal PLOS One. In addition to the strong reactions reflected in the material, the other themes are an erosion of trust in the healthcare system, shifting patient-clinician roles and responsibilities, and confused and conflicting opinions about the legality and ethical basis of covert recordings. Not surprisingly, clinicians have strong negative reactions about the recordings, although some commented on the value of the recordings (e.g., helpful means for patients to recall complex information) while indicating a preference that patients request permission to record. Some of the posts offered guidance (e.g., post a sign prohibiting recording, require written permission to record), and many expressed concerns about privacy and confidentiality as well as the admissibility of covert recordings as evidence in legal settings. The range of opinions about covert recording expressed by patients and clinicians highlights the need for policies and legislative guidance about recording clinical encounters, the authors note.

HRC Recommends: Risk managers should ensure that policies are in place that expressly prohibit recordings without the consent of all involved parties. Although policies are unlikely to stop all surreptitious recordings from taking place, they will give providers something to point to if the issue comes up. In many healthcare settings, such as outpatient settings and medical offices, signage already indicates that patients and family members should turn off cell phones and other electronic devices upon entering the facility or in patient care areas. Concerned providers may consider amending these signs to clarify that they include recording devices. HRC will provide more coverage and recommendations regarding covert recording of clinical encounters in the August 2015 issue of the Risk Management Reporter.