Barr Paul J, Dannenberg Michelle D, Ganoe Craig H, Haslett William, Faill Rebecca, Hassanpour Saeed, Das Amar, Arend Roger, Masel Meredith C, Piper Sheryl, Reicher Haley, Ryan James, Elwyn Glyn
The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
JMIR Res Protoc. 2017 Jul 6;6(7):e121. doi: 10.2196/resprot.7735.
Providing patients with recordings of their clinic visits enhances patient and family engagement, yet few organizations routinely offer recordings. Challenges exist for organizations and patients, including data safety and navigating lengthy recordings. A secure system that allows patients to easily navigate recordings may be a solution.
The aim of this project is to develop and test an interoperable system to facilitate routine recording, the Open Recording Automated Logging System (ORALS), with the aim of increasing patient and family engagement. ORALS will consist of (1) technically proficient software using automated machine learning technology to enable accurate and automatic tagging of in-clinic audio recordings (tagging involves identifying elements of the clinic visit most important to patients [eg, treatment plan] on the recording) and (2) a secure, easy-to-use Web interface enabling the upload and accurate linkage of recordings to patients, which can be accessed at home.
We will use a mixed methods approach to develop and formatively test ORALS in 4 iterative stages: case study of pioneer clinics where recordings are currently offered to patients, ORALS design and user experience testing, ORALS software and user interface development, and rapid cycle testing of ORALS in a primary care clinic, assessing impact on patient and family engagement. Dartmouth's Informatics Collaboratory for Design, Development and Dissemination team, patients, patient partners, caregivers, and clinicians will assist in developing ORALS.
We will implement a publication plan that includes a final project report and articles for peer-reviewed journals. In addition to this work, we will regularly report on our progress using popular relevant Tweet chats and online using our website, www.openrecordings.org. We will disseminate our work at relevant conferences (eg, Academy Health, Health Datapalooza, and the Institute for Healthcare Improvement Quality Forums). Finally, Iora Health, a US-wide network of primary care practices (www.iorahealth.com), has indicated a willingness to implement ORALS on a larger scale upon completion of this development project.
Upon the completion of this project we will have developed a novel recording system that will be ready for large-scale testing. Our long-term goal is for ORALS to seamlessly fit into a clinic's and patient's daily routine, increasing levels of patient engagement and transparency of care.
为患者提供门诊就诊录音可增强患者及其家属的参与度，但很少有机构会常规提供录音服务。机构和患者都面临一些挑战，包括数据安全以及如何在冗长的录音中找到关键信息。一个能让患者轻松浏览录音的安全系统或许是个解决方案。
本项目旨在开发并测试一个可促进常规录音的互操作系统——开放录音自动日志系统（ORALS），以提高患者及其家属的参与度。ORALS将包括：（1）技术精湛的软件，运用自动化机器学习技术对门诊音频录音进行准确自动标记（标记是指识别录音中对患者最重要的门诊就诊要素[如治疗方案]）；（2）一个安全、易用的网络界面，可实现录音的上传以及与患者的准确关联，患者在家中即可访问。
我们将采用混合方法，分4个迭代阶段开发并对ORALS进行形成性测试：对目前向患者提供录音服务的先锋诊所进行案例研究、ORALS设计及用户体验测试、ORALS软件及用户界面开发，以及在初级保健诊所对ORALS进行快速循环测试，评估其对患者及其家属参与度的影响。达特茅斯设计、开发与传播信息协作实验室团队、患者、患者合作伙伴、护理人员及临床医生将协助开发ORALS。
我们将实施一项出版计划，包括一份最终项目报告以及在同行评审期刊上发表文章。除此之外，我们将通过热门的相关推文聊天以及在我们的网站www.openrecordings.org上定期报告进展情况。我们将在相关会议（如健康学会、健康数据节以及医疗保健改进研究所质量论坛）上传播我们的研究成果。最后，美国全国性的初级保健机构网络Iora Health（www.iorahealth.com）表示，在这个开发项目完成后，愿意大规模实施ORALS。
本项目完成后，我们将开发出一个新型录音系统，准备好进行大规模测试。我们的长期目标是让ORALS无缝融入诊所和患者的日常工作中，提高患者参与度和医疗透明度。
