You will be required to wear a bodycam

[Birdstrike]

Healthcare workers will be required to wear a body cam at all times. It will be sold to the public as for "patient safety." It will be sold you as a means to "reduce lawsuits" and "to reduce violence against healthcare workers." They're sorting out the details of HIPAA compliance, safe transfer and storage in the EHR.

When implemented, the actual reason will be none of the above. It will be because they found a way to make it profitable, better track metrics (they know these are being gamed), enforce patient satisfaction, remove inefficient staff and 'non-team players,' including doctors. Everything you'll say and do, will be on tape, from the minute you walk in the door, until you leave. Refusing to wear the cam, will be grounds for termination.

Once the Hospital-Government-CMG-Complex has ensured the profitability of the practice, it's implementation will be unstoppable.

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[panscan]

“Hi, I’m Dr. Panscan. I would like to do a pelvic exam to obtain cultures. Don’t worry about this huge camera hanging around my neck. No, I don’t know who watches this footage.”

 

[Sushirolls]

Finally! There will be an end to those personal beverages at the nursing station! They have plagued the ED for decades. Such a bright shiny future ahead.

 

[GeneralVeers]

I don't think it's beyond the realm of possibility. Will also enforce 100% mask compliance, even while charting alone in a separate room away from everyone.

 

[Birdstrike]

I don't think it's beyond the realm of possibility. Will also enforce 100% mask compliance, even while charting alone in a separate room away from everyone.

ED Physician body cams will beta tested with EMS first, then moved into EDs once the financial and surveillance benefits, to the Hospital-Government-CMG Complex, have been assured, and the legalities finessed. Physicians at the NIH have been planning this for quite some time now, with the knowledge of notable figures in EM.

 

[southerndoc]

Finally! There will be an end to those personal beverages at the nursing station! They have plagued the ED for decades. Such a bright shiny future ahead.

I like showing off my bathroom habits.

 

[southerndoc]

ED Physician body cams will beta tested with EMS first, then moved into EDs once the financial and surveillance benefits, to the Hospital-Government-CMG Complex, have been assured, and the legalities finessed. Physicians at the NIH have been planning this for quite some time now, with the knowledge of notable figures in EM.

There are some jurisdictions that actually use EMS bodycams.

 

[MechEDoc]

Finally! There will be an end to those personal beverages at the nursing station! They have plagued the ED for decades. Such a bright shiny future ahead.

I'm sure nursing unions will find some way to automatically have physician body cameras not record in their presence. "Nurse safety" or something like that. Ever notice how many nurses obscure their name on their hospital IDs?

https://nymag.com/intelligencer/2016/01/chicago-police-officers-tampered-with-dash-cams.html

 

[wareagle726]

They just installed cameras in patient rooms at one of our facilities. States "they don't record, it's only for when we are holding for tele-nursing staff to help with overflow."

 

[GeneralVeers]

They just installed cameras in patient rooms at one of our facilities. States "they don't record, it's only for when we are holding for tele-nursing staff to help with overflow."

#bigbrother is watching you.

 

[Franzd'Epinay]

Physicians at the NIH have been planning this for quite some time now, with the knowledge of notable figures in EM.

It wouldn't surprise me if someone is researching the effects of recording healthcare encounters. The NIH being the source of a lot of research funding makes sense.

But I'd like to hear more about this "planning" you are describing--that wording implies something different.

 

[Tenk]

This won’t happen while we’re in practice. The overhead on this would be absolutely insane and outweigh any potential financial benefit with current tech. Also, I’m pretty sure in many states this would be against the law (even without hipaa) due to two party consent as you’d have to be out of your mind to consent to that.

 

[The Knife & Gun Club]

This won’t happen while we’re in practice. The overhead on this would be absolutely insane and outweigh any potential financial benefit with current tech. Also, I’m pretty sure in many states this would be against the law (even without hipaa) due to two party consent as you’d have to be out of your mind to consent to that.

I agree.

Also I’d imagine the vast majority of PATIENTS would balk at this. For every patient who attempts to record me with their cell phone, there’s 2-3 who lean in close after the nurse leaves the room and says “to tell you the truth doc, I’m on truvada for you know what” or “hey don’t tell my SO but I have 69 other sexual partners, and a baby momma on the back burner.”

No way they’d be down for recording this nonsense

 

[Frazier]

What I have seen done at another ED in the midwest is a radiofrequency device/badge that apparently tracked staff's movement/locations in realtime... I imagine that could accomplish the admin goals without many of the privacy issues.

I don't know if they still use that technology -- it would have been about 5 years ago

 

[southerndoc]

What I have seen done at another ED in the midwest is a radiofrequency device/badge that apparently tracked staff's movement/locations in realtime... I imagine that could accomplish the admin goals without many of the privacy issues.

I don't know if they still use that technology -- it would have been about 5 years ago

We have this feature, but only for safety issues. Because our ED is so big and we encourage closing the doors (except with a known or potential violent patient), we track staff. One push of the panic button gets security/police at the bedside pretty quickly. I accidentally pushed it one day.

 

[Tenk]

What I have seen done at another ED in the midwest is a radiofrequency device/badge that apparently tracked staff's movement/locations in realtime... I imagine that could accomplish the admin goals without many of the privacy issues.

I don't know if they still use that technology -- it would have been about 5 years ago

We were given them years ago, I never wore it, nobody ever said a word to me. Just another useless waste of money that could have gone to doctors or nurses. Ridiculous.

 

[Mad Jack]

This won’t happen while we’re in practice. The overhead on this would be absolutely insane and outweigh any potential financial benefit with current tech. Also, I’m pretty sure in many states this would be against the law (even without hipaa) due to two party consent as you’d have to be out of your mind to consent to that.

Yeah, wouldn't be legal in my state without significant changes to wiretapping laws. It took many years for the legislature to create a loophole for police officers specifically, and that required specific lobbying by police unions to happen. I can't see them doing it for physicians, unless it was something physicians heavily lobbied for over several years as the police had to do. If there was *any* resistance the law wouldn't pass.

 

[Mad Jack]

What I have seen done at another ED in the midwest is a radiofrequency device/badge that apparently tracked staff's movement/locations in realtime... I imagine that could accomplish the admin goals without many of the privacy issues.

I don't know if they still use that technology -- it would have been about 5 years ago

I've worked in two hospitals in the Northeast that use RFID badges to track nursing staff. They're actually pretty useful on very large floors in tracking down the person you need but I've never heard of the tracking being used for disciplinary action

 

[HoosierdaddyO]

Yea I’m sure patients would love having their personal conversations recorded for safety🙄?!

Doc: so what brings you in?
Patient: I’m afraid to tell you about this open sore I have on my penis bc the conversation is being recorded.

I don’t think it’ll fly in a healthcare setting. Doesn’t mean the C suite won’t try to push it through!!!

 

[MechEDoc]

What I have seen done at another ED in the midwest is a radiofrequency device/badge that apparently tracked staff's movement/locations in realtime... I imagine that could accomplish the admin goals without many of the privacy issues.

I don't know if they still use that technology -- it would have been about 5 years ago

I've had that tried on me (back when jobs were plentiful), I clipped that thing to the portable x-ray machine and never saw it again

 

[Apollyon]

There was a series on PBS from the UK that I just completed. It's called "Summer of Rockets". The protagonist is a guy that makes hearing aids, and has a new product he calls the "staff annuciator"; it was really an early beeper. (The series is set in 1958.) That reminded me of when I was a resident. In the PICU, only one of the docs (unlike all the nurses) wore one of those locators. I asked him, and he said that he wanted them to be able to get him immediately if they needed him.

On service, I can see the utility. Body cams? No way. No one would ever be honest about their problem. But, I am also reminded about UPS, who, even 25 years ago, counted how many turns of the wrench were needed to tighten a nut on a bolt. As someone said, we're all widgets. Irony is, we're not a dime a dozen. But, we sure act like it!

 

[bravotwozero]

Irony is, we're not a dime a dozen. But, we sure act like it!

We're not? with a job shortage and lots of diploma mills out now, we will be soon enough!

 

[Apollyon]

We're not? with a job shortage and lots of diploma mills out now, we will be soon enough!

I just meant the training. They'll learn soon enough, when a shyster puts up a billboard saying, "Were you or a family member injured or killed at Smith Community Hospital? You may have a case!" Money talks. Docs are expensive? Mid-level plus judgment is a whole lot more!

 

[docB]

I think Birdstrike is right and this will creep into our lives. The privacy stuff is easily overcome especially since this is all covered by HIPAA. Every call to a doctor's office or insurer is already recorded. Procedures are recorded with video. Imaging is recorded. And there are a lot of reasons the industry would want to do this.
- They could better punish doctors for PG failures. "See docB, right here on the video, how you failed to validate this patient's ridiculous misperception? Bad docB! No biscuit! You're fired!"
- The med mal business would save money. Individual docs would suffer but on the whole it would be cheaper. You are either screwed or vindicated by the video. I'm not suggesting that correlates with right and wrong. I'v sure it wouldn't. But it would likely eliminate a lot of the lawyer churn, expert lying, endless depos, and so on.
- We really wouldn't have to chart HPIs, ROSs and PEs. That would all be on video. We'd do the MDM and the Dx. The coders would still be locked up in a basement somewhere but instead of picking through 50 charts an hour they'd be watching video Clockwork Orange style at 3x speed checking off you 12 point ROS. We'd have to call out the PE findings as we do them "No abdominal TTP here." If we didn't have to chart they could flog us to where we see 10 patients an hour. The stockholders will be pleased.

 

[GeneralVeers]

I think Birdstrike is right and this will creep into our lives. The privacy stuff is easily overcome especially since this is all covered by HIPAA. Every call to a doctor's office or insurer is already recorded. Procedures are recorded with video. Imaging is recorded. And there are a lot of reasons the industry would want to do this.
- They could better punish doctors for PG failures. "See docB, right here on the video, how you failed to validate this patient's ridiculous misperception? Bad docB! No biscuit! You're fired!"
- The med mal business would save money. Individual docs would suffer but on the whole it would be cheaper. You are either screwed or vindicated by the video. I'm not suggesting that correlates with right and wrong. I'v sure it wouldn't. But it would likely eliminate a lot of the lawyer churn, expert lying, endless depos, and so on.
- We really wouldn't have to chart HPIs, ROSs and PEs. That would all be on video. We'd do the MDM and the Dx. The coders would still be locked up in a basement somewhere but instead of picking through 50 charts an hour they'd be watching video Clockwork Orange style at 3x speed checking off you 12 point ROS. We'd have to call out the PE findings as we do them "No abdominal TTP here." If we didn't have to chart they could flog us to where we see 10 patients an hour. The stockholders will be pleased.

I'm not certain we will have video records, it will be audio-only for "Patient Privacy" and designed mainly to protect the hospital. Why have coder's pore over video records for charting when we can still force physicians to do it for free and document 10 ROS by using a clunky, non-intuitive interface?

 

[Birdstrike]

I'm not certain we will have video records, it will be audio-only for "Patient Privacy" and designed mainly to protect the hospital. Why have coder's pore over video records for charting when we can still force physicians to do it for free and document 10 ROS by using a clunky, non-intuitive interface?

Wait. You guys still have to do a 10-point ROS? As of Jan 1 (at least for outpatient) that all went away. Assessment and Plan are all that matters for our billing now. Did they keep that only for EM?

 

[southerndoc]

Wait. You guys still have to do a 10-point ROS? As of Jan 1 (at least for outpatient) that all went away. Assessment and Plan are all that matters for our billing now. Did they keep that only for EM?

It's coming, but not fully implemented yet. CMS will implement first and then the private insurers will join a little later.

 

[FutureInternist]

I think Birdstrike is right and this will creep into our lives. The privacy stuff is easily overcome especially since this is all covered by HIPAA. Every call to a doctor's office or insurer is already recorded. Procedures are recorded with video. Imaging is recorded. And there are a lot of reasons the industry would want to do this.
- They could better punish doctors for PG failures. "See docB, right here on the video, how you failed to validate this patient's ridiculous misperception? Bad docB! No biscuit! You're fired!"
- The med mal business would save money. Individual docs would suffer but on the whole it would be cheaper. You are either screwed or vindicated by the video. I'm not suggesting that correlates with right and wrong. I'v sure it wouldn't. But it would likely eliminate a lot of the lawyer churn, expert lying, endless depos, and so on.
- We really wouldn't have to chart HPIs, ROSs and PEs. That would all be on video. We'd do the MDM and the Dx. The coders would still be locked up in a basement somewhere but instead of picking through 50 charts an hour they'd be watching video Clockwork Orange style at 3x speed checking off you 12 point ROS. We'd have to call out the PE findings as we do them "No abdominal TTP here." If we didn't have to chart they could flog us to where we see 10 patients an hour. The stockholders will be pleased.

My previous job started using Google glasses for some outpt encounters.

It is as you said, in that the doc would do their HPI, ROS, and then narrate the physical exam findings, and tell pt the plan.

By the time they would leave, the medical transcriptionists had the whole note done.

Not sure how one would get around not filming while in the hallways where one could turn and look towards anyone? 🤔

Maybe something attached to doors that automatically shuts camera off when you leave?

Either way, a bad bad future to not look forward to

 

[docB]

My previous job started using Google glasses for some outpt encounters.

It is as you said, in that the doc would do their HPI, ROS, and then narrate the physical exam findings, and tell pt the plan.

By the time they would leave, the medical transcriptionists had the whole note done.

Not sure how one would get around not filming while in the hallways where one could turn and look towards anyone? 🤔

Maybe something attached to doors that automatically shuts camera off when you leave?

Either way, a bad bad future to not look forward to

I always thought they'd pair it with the RFID chips several people were talking about before. You walk into a room, the computer recognizes that you're having an interaction with patient 449588395058389 and the recording starts, tagged to their MRN. Then it will turn out we were actually at war with Eastasia all along.

 

[Franzd'Epinay]

My previous job started using Google glasses for some outpt encounters.

It is as you said, in that the doc would do their HPI, ROS, and then narrate the physical exam findings, and tell pt the plan.

By the time they would leave, the medical transcriptionists had the whole note done.

Not sure how one would get around not filming while in the hallways where one could turn and look towards anyone? 🤔

Maybe something attached to doors that automatically shuts camera off when you leave?

Either way, a bad bad future to not look forward to

What's the benefit of the Google glass over just using one of those audio-only remote scribe services?

 

[FutureInternist]

What's the benefit of the Google glass over just using one of those audio-only remote scribe services?

Not sure.
Maybe they were getting some $ from Google to pilot it?
I guess the doc doesn’t have to say “Oh your RUQ is TTP” since the scribe can see where they are palpating.
Either way, its defunct now so maybe we stave this off for a little while longer, while we encourage our kids to go into something else... 😏

 

[FutureInternist]

I always thought they'd pair it with the RFID chips several people were talking about before. You walk into a room, the computer recognizes that you're having an interaction with patient 449588395058389 and the recording starts, tagged to their MRN. Then it will turn out we were actually at war with Eastasia all along.

Dude/Dudette,
DON’T give them any ideas.. 😏

 

[BoardingDoc]

I always thought they'd pair it with the RFID chips several people were talking about before. You walk into a room, the computer recognizes that you're having an interaction with patient 449588395058389 and the recording starts, tagged to their MRN. Then it will turn out we were actually at war with Eastasia all along.

I thought we've always been at war with Eastasia

 

[thegenius]

I know this is going to sound ridiculous, but it seems untenable to record video of space and time in every ER in the nation (and of all of health care in the US) and have it archived for 7-10 years due to the massive amount of disk storage needed for this, and the cost of maintaining such a thing.

I'm fully aware of how little disk storage costs, but it's not clear that we can just divine up extra petabytes (10^15), bordering on exabytes (10^18) of storage over the next 5-10 years. Just imagine too that the vast majority of that information stored is just a waste. Maybe 1 day's worth of police body cam footage per year would be interesting or necessary to store and the other 250 days worth is just nonsense garbage being archived.

Anyway...interesting conversation.

 

[wendalltwolf]

I know this is going to sound ridiculous, but it seems untenable to record video of space and time in every ER in the nation (and of all of health care in the US) and have it archived for 7-10 years due to the massive amount of disk storage needed for this, and the cost of maintaining such a thing.

I'm fully aware of how little disk storage costs, but it's not clear that we can just divine up extra petabytes (10^15), bordering on exabytes (10^18) of storage over the next 5-10 years. Just imagine too that the vast majority of that information stored is just a waste. Maybe 1 day's worth of police body cam footage per year would be interesting or necessary to store and the other 250 days worth is just nonsense garbage being archived.

Anyway...interesting conversation.

Magnetic tape storage is surprisingly still around and 1 library can apparently hold 278 petabytes (Full Page Reload), so maybe it’s still possible to keep all that video stored somewhere...

 

[southerndoc]

I know this is going to sound ridiculous, but it seems untenable to record video of space and time in every ER in the nation (and of all of health care in the US) and have it archived for 7-10 years due to the massive amount of disk storage needed for this, and the cost of maintaining such a thing.

I'm fully aware of how little disk storage costs, but it's not clear that we can just divine up extra petabytes (10^15), bordering on exabytes (10^18) of storage over the next 5-10 years. Just imagine too that the vast majority of that information stored is just a waste. Maybe 1 day's worth of police body cam footage per year would be interesting or necessary to store and the other 250 days worth is just nonsense garbage being archived.

Anyway...interesting conversation.

Most police departments I know destroy the recordings after 30 days unless they are needed for an investigation/arrest.