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What EMS should know before recording?
EMS call audio/video recording has been debated https://www.thelegalguardian.com. The dialogue may be about recording video for training or quality assurance, protecting patients and clinicians from charges of misbehavior or damage, or protecting employers from employee mischief and misconduct Professional License Defense Attorney. Accidents, assaults, and medical blunders are increasing in EMS, therefore protecting staff and patients is crucial. While cameras and other imaging devices can improve scene safety, provide real-time documentation, and improve quality, recording medical encounters, whether audio or video, raises ethical, privacy, and legal issues that must be addressed before implementing new technology and putting cameras in the field.
The importance of getting consent
"This call may be monitored or recorded for training and quality improvement reasons" is a common greeting on customer service hotlines. Reasons exist. Many states restrict audio and video recording without at least knowledge and agreement from all parties. Whether the recording is for quality assurance or improvement, this is true. Most states have comparable video regulations, however some have a lower requirement for third-party notice of video recording. Thus, an ambulance notice alerting patients of video cameras and recording equipment may be necessary. However, that will only help until you put the patient into the ambulance, and it raises the issue of consent or notice for body-worn camera video recording on the scene (i.e., at the patient's home or in the street).
If your patient is unconscious, disabled, or unable to agree, you cannot record the call Professional Licensing Attorney. Implied Consent does not apply. Implied In the event a person is suffering from a life- or limb-threatening condition and is unable to give informed consent to medical care, health care practitioners may lawfully treat them to save their life, assuming a reasonable person would seek for medical care if they could. The theory only applies to life-saving medical intervention, not to audio or video recordings. To utilize the audio or video for quality assurance or training, authorization is still needed. What if the patient refuses consent to film the encounter? You would need to be able to turn the recording device on and off at whim and take time away from patient care to get consent, including explaining why you should record the session. That dialogue is difficult and time-consuming.
The logistics of managing recordings
Also, patient care recordings must be retained alongside the patient's medical record. Even rear-facing cameras in an ambulance's patient compartment that capture medical care without positive identification of the patient (i.e., you cannot see the patient's face) must be preserved and attached to the patient's medical record if they show even peripheral treatment, such as IV insertion or intubation. Do you have a means to include or encode metadata (digital "tags" or codes that define and offer information about the video) into the video to correctly identify the patient and upload it to attach or link it to the rest of the patient's medical documents (ePCR, field lab results)? Does your EMS organization have computer systems that can save hundreds of hours of audio and video recordings for as long as you must retain the patient's medical record?
What IT security measures prevent the recordings from being accessed, hacked, or posted online? HIPAA and HITECH requirements relate to recording storage and usage. Before introducing any data or digital imagery-generating device, they must be reviewed and handled. The patient, not the caregiver, controls who sees or receives the medical record, with several limitations. Thus, a patient can legally refuse to allow others to see their photograph. |
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