Voice Recorders

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dschambers3

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Hello everyone! I was wondering do any of you use voice recorders while your on calls, to help on your documentation? I have considered doing this because I am always worried about forgetting to write something down. Is this to close to HIPAA violation? Thanks?
 
I suppose if you deleted the recordings once you wrote the report, it might be alright.

I have toyed with taking pictures of vehicles to show doctors at the ER so that they better assess the patient.
 
Well personally I would not recommend a voice recorder. At what point are you going to be speaking into this thing, or do you mean something that continuously records your entire interview?

How do you think the patient will feel about it? You should also inform them at the start that they are being recorded as well. Now I don't know about you, but I have run across many patients in precarious situations that would extremely object to being recorded. I also would never get some vital information pertinent to their exam or history had I been recording.

Also, if this is some sort of questionable patient (crime, assault, rape, whatever) and the police know about your recording, or your service knows of this practice, the possibility exists that your recordings could be declared as evidence. I certainly do not want any recordings of me in a court of law ever. It has been a scary enough experience when just my reports were there and I was testifying.

It seems like a very bad idea. I would just practice over and over with your exam questions, and eventually you will formulate a pattern that works for you, one that flows every time.

Practice practice practice. It is ok to be nervous and none of us were doing the perfect, error free patient interview from the get go.

As for taking pictures on scene, this is a bad idea for a couple reasons.

1. Possible privacy invasions/complaints

2. Loss of control of the photos ( you share with a buddy, they get on the net, then see #1) This has already happened unfortunately

3. It does NOT help the doctor perform a better exam. The doctor should perform the same exam for every patient regardless of how the vehicle looks.

Damage of a vehicle is not a good indicator of injury. I have had multiple roll overs where they walked away, and then I have had fender benders with critical patients.

The Level I trauma center I used to transport to asked us specifically to STOP bringing in Polaroids because they did not want to tunnel vision their assessments. They wanted to do a complete and detailed exam every time with no preconceived notions of what potential injuries may exist by glancing at a picture. It did nothing for them or their assessments.

Newer cars are made to crumple to absorb impact, so a low impact, no injured patient may still present as the most awful wreck you ever seen until you delve deeper into your exam and realize the pt is ok.

Older cars were heavier and did not crumple, so while the car may look undamaged, the patient probably is not, as they absorbed the impact with their bodies.
 
I dont think he mean't Record the entire call, I think he mean't. Something like this.


Hit record: "The patients Base line vitals are, blah blah blah blah"

Personally I just have a little sticky paper on my leg or I write on the back of my glove.

Ive never seen anyone use a voice recorder. But I have heard of people doing it.
 
If you are involved with a VFD you could check with them or do some research on your area's Rules with documentation.
 
akflightmedic said:
Well personally I would not recommend a voice recorder. At what point are you going to be speaking into this thing, or do you mean something that continuously records your entire interview?

How do you think the patient will feel about it? You should also inform them at the start that they are being recorded as well. Now I don't know about you, but I have run across many patients in precarious situations that would extremely object to being recorded. I also would never get some vital information pertinent to their exam or history had I been recording.

Also, if this is some sort of questionable patient (crime, assault, rape, whatever) and the police know about your recording, or your service knows of this practice, the possibility exists that your recordings could be declared as evidence. I certainly do not want any recordings of me in a court of law ever. It has been a scary enough experience when just my reports were there and I was testifying.

It seems like a very bad idea. I would just practice over and over with your exam questions, and eventually you will formulate a pattern that works for you, one that flows every time.

Practice practice practice. It is ok to be nervous and none of us were doing the perfect, error free patient interview from the get go.

As for taking pictures on scene, this is a bad idea for a couple reasons.

1. Possible privacy invasions/complaints

2. Loss of control of the photos ( you share with a buddy, they get on the net, then see #1) This has already happened unfortunately

3. It does NOT help the doctor perform a better exam. The doctor should perform the same exam for every patient regardless of how the vehicle looks.

Damage of a vehicle is not a good indicator of injury. I have had multiple roll overs where they walked away, and then I have had fender benders with critical patients.

The Level I trauma center I used to transport to asked us specifically to STOP bringing in Polaroids because they did not want to tunnel vision their assessments. They wanted to do a complete and detailed exam every time with no preconceived notions of what potential injuries may exist by glancing at a picture. It did nothing for them or their assessments.

Newer cars are made to crumple to absorb impact, so a low impact, no injured patient may still present as the most awful wreck you ever seen until you delve deeper into your exam and realize the pt is ok.

Older cars were heavier and did not crumple, so while the car may look undamaged, the patient probably is not, as they absorbed the impact with their bodies.
Click to expand...


all good points. This why I have thought about it but haven't done it.
 
Topher38 said:
If you are involved with a VFD you could check with them or do some research on your area's Rules with documentation.
Click to expand...

HIPPA rules are for everyone, not just VFD...

unless a person plans on erasing the info at the end of every call, HIPPA is clear about what has to happen to private patient info.

you should do research into the HIPPA regulations to familiarize yourself with them.

for example, a person shows up at the station, says he was transported by your agency last week, and wants his PCR. what do you do?
 
akflightmedic said:
Well personally I would not recommend a voice recorder. At what point are you going to be speaking into this thing, or do you mean something that continuously records your entire interview?

How do you think the patient will feel about it? You should also inform them at the start that they are being recorded as well. Now I don't know about you, but I have run across many patients in precarious situations that would extremely object to being recorded. I also would never get some vital information pertinent to their exam or history had I been recording.

Also, if this is some sort of questionable patient (crime, assault, rape, whatever) and the police know about your recording, or your service knows of this practice, the possibility exists that your recordings could be declared as evidence. I certainly do not want any recordings of me in a court of law ever. It has been a scary enough experience when just my reports were there and I was testifying.

It seems like a very bad idea. I would just practice over and over with your exam questions, and eventually you will formulate a pattern that works for you, one that flows every time.

Practice practice practice. It is ok to be nervous and none of us were doing the perfect, error free patient interview from the get go.

As for taking pictures on scene, this is a bad idea for a couple reasons.

1. Possible privacy invasions/complaints

2. Loss of control of the photos ( you share with a buddy, they get on the net, then see #1) This has already happened unfortunately

3. It does NOT help the doctor perform a better exam. The doctor should perform the same exam for every patient regardless of how the vehicle looks.

Damage of a vehicle is not a good indicator of injury. I have had multiple roll overs where they walked away, and then I have had fender benders with critical patients.

The Level I trauma center I used to transport to asked us specifically to STOP bringing in Polaroids because they did not want to tunnel vision their assessments. They wanted to do a complete and detailed exam every time with no preconceived notions of what potential injuries may exist by glancing at a picture. It did nothing for them or their assessments.

Newer cars are made to crumple to absorb impact, so a low impact, no injured patient may still present as the most awful wreck you ever seen until you delve deeper into your exam and realize the pt is ok.

Older cars were heavier and did not crumple, so while the car may look undamaged, the patient probably is not, as they absorbed the impact with their bodies.
Click to expand...


the ER's in our area REQUIRE us to bring polaroids of MVA's..

there is no "loss of control" issue, as the pics are left with the ER.

has NOTHING to do with them performing an exam, but has EVERYTHING to do with helping them to understand the mechanism.. why do we look at the damage? why do we inspect the interior? to determine what the mechanism is and where it should lead us.
since the ER doc is not there to see it, what better way to help relate mechanism that to show photos. I'm sure they will be able to decide if it helps their assessment or not.

i'm sure it was unintended, but your post implies that mechanism is unimportant, and you will do the same exam no matter what.
 
The ER's in your area Require you guys to use polaroids of MVAs?

Thats pretty cool. Thats a good idea too.
 
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JPINFV said:
HIPAA actually only applies to providers who use electronic billing.
http://www.cms.hhs.gov/HIPAAGenInfo/06_AreYouaCoveredEntity.asp

Of course, ethically speaking, patient privacy doesn't depend on if your agency bills or not.
Click to expand...

sorry, just flat out wrong here.

we are a volly agency, and do no electronic billing. you are saying that we are free to do what we like with the patient info, and are not bound by HIPPA?

i can tell you, that is just plain wrong, and i have a HIPPA manual for volunteer agencies outlining what we can and can not do.
 
Well, if that's the case then the HIPAA website is wrong as well. Check the link if you don't believe me.

The Administrative Simplification standards adopted by Health and Human Services (HHS) under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply to any entity that is

* a health care provider that conducts certain transactions in electronic form (called here a "covered health care provider").
* a health care clearinghouse.
* a health plan.

An entity that is one or more of these types of entities is referred to as a "covered entity" in the Administrative Simplification regulations.
Click to expand...

http://www.cms.hhs.gov/HIPAAGenInfo/06_AreYouaCoveredEntity.asp

Q. Is a volunteer ambulance service subject to the HIPAA rules?
A. A volunteer ambulance service is a covered provider and is required to comply with the HIPAA transactions, privacy, and security rules, if the service transmits any standard transaction, including a claim for services, in an electronic form.
Click to expand...
http://www.nd.gov/hipaa/misc/faq.html#k


There might also be local laws that cover medical privacy that your agency might deal with when HIPAA doesn't apply.
 
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dschambers3 said:
Hello everyone! I was wondering do any of you use voice recorders while your on calls, to help on your documentation? I have considered doing this because I am always worried about forgetting to write something down. Is this to close to HIPAA violation? Thanks?
Click to expand...

We are not allowed to have any sort of recording device whatsoever in the unit or on a call. No video, no audio, no photo, no nothing.
 
I am a memeber of 2 volley agencies. HIPPA training is required of all riding members because HIPPA applies to us. Many volley agencies bill medicare and insurance companies through a soft billing process. We are required to have certain medicare forms filled out by patients that were usually only required by transport companies.
 
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skyemt said:
HIPPA rules are for everyone, not just VFD...

unless a person plans on erasing the info at the end of every call, HIPPA is clear about what has to happen to private patient info.

you should do research into the HIPPA regulations to familiarize yourself with them.

for example, a person shows up at the station, says he was transported by your agency last week, and wants his PCR. what do you do?
Click to expand...


Actually HIPPA language is very clearly specific to billing agencies (as it is indeed the theHealth Insurance Portability and Accountability Act ) , BUT you are in fact correct that it is the responsibility of the VFD (or whomever) to meet the current standard of care which includes observance of privacy in regards to PHI and EPHI addressed by text in the act.

Just nit-picking here.
 
Topher38 said:
I dont think he mean't Record the entire call, I think he mean't. Something like this.


Hit record: "The patients Base line vitals are, blah blah blah blah"

Personally I just have a little sticky paper on my leg or I write on the back of my glove.

Ive never seen anyone use a voice recorder. But I have heard of people doing it.
Click to expand...

Even stopping and hitting record and then repeating what you just found out or what the patient told you, how well do you think the interview will flow?

Will this "stop and go" method delay you from doing other things as well?

Will this behavior instill confidence in the patient regarding your compentency? Will it make them more anxious to be treated by you?

Will relying on this method help you become a more competent provider?

If the patient is stable enough for you to hit record and repeat, then they are stable enough for you to take the time to write it down.

I am just trying to throw out some food for thought, but all around it is still a bad idea in my opinion.
 
rgnoon said:
Actually HIPPA language is very clearly specific to billing agencies (as it is indeed the theHealth Insurance Portability and Accountability Act ) , BUT you are in fact correct that it is the responsibility of the VFD (or whomever) to meet the current standard of care which includes observance of privacy in regards to PHI and EPHI addressed by text in the act.

Just nit-picking here.
Click to expand...


And yet again, just to nit pick...lol, I am glad to see someone knows what HIPAA stands for,but yet again not surprised at how many people mispell it.

Yes this is not grammar class, but this is an educational and professional issue. We definitely should know how to spell words that are critical to our profession.

Wink Wink this is all said with tongue in cheek, and is mostly just to be an informative remark not a mean one.

HIPAA only applies to agencies that bill for services. So yes, to quote one poster, technically your VFD could do whatever they want with patient information however ethically it is not the right thing to do. See above post as well, good response. Therefore most agencies just use a blanket policy and make everyone conform to it. It is a good practice to get used to anyways, makes the provider more aware that the information that they are obtaining from the patient IS sensitive and not just a name and number with no meaning that could never bring harm upon the individual.

Please bare in mind I am not a medical lawyer and do not claim to be the authority on such matters, please consult your local leagl rep for further clarification.
 
Recording calls could be a good tool for quality control/training methods. It could also be a good tool to protect EMTs from malicious accusations. Of course such recordings would need to be kept private and off the internet.
 
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