Patients videotaping in the ED

[ERDude]

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Have you guys run into patients or their families pulling out their cell phones and doing video taping in the ED? Specifically procedures or code situations?

I haven't personally had this happen, but I've had some colleagues that have.

Even though I know we are all doing the right thing, irrespective of video documentation, I could see this as being a concerning trend (and possible hipaa violation if other patient's names/info are inadvertently recorded).

Do your EDs have policies in place to try and prevent this? Do you think we should?

 

[Foster23]

Have you guys run into patients or their families pulling out their cell phones and doing video taping in the ED? Specifically procedures or code situations?

I haven't personally had this happen, but I've had some colleagues that have.

Even though I know we are all doing the right thing, irrespective of video documentation, I could see this as being a concerning trend (and possible hipaa violation if other patient's names/info are inadvertently recorded).

Do your EDs have policies in place to try and prevent this? Do you think we should?

we have a policy specifically prohibit video taping or taking pictures in the ED.
Personally, I have let patient's family member snap a picture of a laceration before and after, but not during the procedure.

 

[WilcoWorld]

I would never allow a code to be video-taped by a patient's family member. I think it's grossly indecent. However, in cases where patients requested it, I have allowed their friends/family to video I&Ds. It's gross, but not indecent.

Codes video-taped for educational or systems-analysis purposes have a different motivation, and I think this makes them acceptable. But only when the proper precautions are taken (mostly privacy).

 

[CTRadAid]

I tell all patients to turn off their phone immediately if I see them use it. Can't have it interfering with the equipment (even if that is mostly bull...).

 

[Guero]

What would you all do if the pt/family refused your orders? Is that something you'd get security involved with or for which you'd threaten to withhold care?

 

[RustedFox]

Never had anyone take video, but the cellphone thing really gets me mad. Put your freaking phone away. I need your attention. Period.

 

[inspirationmd]

For a code! If they didn't listen and were taping security would absolutely be throwing them out. Personally I think the whole witnessed CPR outside of very few situations is a stupid idea anyway. Nothing worse than coding someone and trying to find out when the last Epi was with the heavily Pentecostal family chanting loudly in the background. Kind of counterproductive in the moment with the resuscitation.

Anything else I guess it would depend. If try are taping my H&P then that smells litigious and then the equipment interference idea would get employed.

 

[RustedFox]

I have had patients hold up the phone at me (presumably, there's an interested family member on the other end) when I go to reassess/give results/counsel/etc. I state, plainly and firmly - "I'm sorry, but I have to have you turn that off." They say something like - "No, its okay, its my sister, she wants to know." I say - "Yes, but this is a patient information/privacy matter. I don't know who it really is on the other end of the phone, and I don't have either implied or written consent to share patient information. Please, turn off the phone."

 

[Guero]

I have had patients hold up the phone at me (presumably, there's an interested family member on the other end) when I go to reassess/give results/counsel/etc. I state, plainly and firmly - "I'm sorry, but I have to have you turn that off." They say something like - "No, its okay, its my sister, she wants to know." I say - "Yes, but this is a patient information/privacy matter. I don't know who it really is on the other end of the phone, and I don't have either implied or written consent to share patient information. Please, turn off the phone."

These are great tactics and rationale to learn. Thank you all for contributing. Please continue.

 

[RustedFox]

These are great tactics and rationale to learn. Thank you all for contributing. Please continue.

Thanks.

I have several "rehearsed lines" that I use when I need to make a point, or control a situation or its response. One that jumps to mind:

"I know that you're in a tough spot, but right now I am acting in your medical best interest. Its not an easy thing to do, for you or for me - but I'm here to give you the best science I can, and the most realistic plan for moving forward here. I will be direct when I say this: (something like "more narcotics are going to do you more harm", "the danger is clear and present, I think that you need to be admitted"... etc,etc.)

 

[Guero]

Thanks.

I have several "rehearsed lines" that I use when I need to make a point, or control a situation or its response. One that jumps to mind:

"I know that you're in a tough spot, but right now I am acting in your medical best interest. Its not an easy thing to do, for you or for me - but I'm here to give you the best science I can, and the most realistic plan for moving forward here. I will be direct when I say this: (something like "more narcotics are going to do you more harm", "the danger is clear and present, I think that you need to be admitted"... etc,etc.)

Beautiful! I've also been asking my mentors how to redirect tangential pts. Maybe I should make a thread to address that if one doesn't already exist. I have a great one liner that our chief of primary care uses that ppl might find useful.

 

[dsoz]

I am just a lowly pre-med that volunteers in a small tertiary ED. But where I am has such poor cell reception, presumidly from the shielding in the walls so they can use the x ray machine. No reception means no calls. Although I guess they can still video.

 

[RustedFox]

Beautiful! I've also been asking my mentors how to redirect tangential pts. Maybe I should make a thread to address that if one doesn't already exist. I have a great one liner that our chief of primary care uses that ppl might find useful.

Then you better tell us what it is, maan. 🙂

 

[Guero]

Then you better tell us what it is, maan. 🙂

"I'd like to hear more about that a little later; but right now, what really concerns me is X."

Thoughts? I thought it was pretty clever, acknowledging the pt and gently redirecting to the more pressing issues, even if what you "want to hear more about later" is a long and drawn out tangent about how Auntie Flo's hemorrhoids went away with witch hazel. LoL

 

[monkeybutt]

I had a patient's family member videoing our mostly open high-acuity area. The nurse called security on them and security watched while the offender deleted thevideo from h cell phone.

 

[southerndoc]

What would you all do if the pt/family refused your orders? Is that something you'd get security involved with or for which you'd threaten to withhold care?

Most patients stop recording when I ask, but I've had one that refused to stop recording. I told them Georgia law allows one to record with only one party knowing about it, but it's illegal to record a conversation if the other party objects. They quickly stopped recording after that.

 

[ER PA]

Ive had a few people pull out phones for procedures, I even had a teenager try to take pictures of his girlfriends neuro exam. I tell them it is illegal to take pictures/videos. If they dont take that seriously I tell them I will call security if they do not put the phone up, and that has always worked. Our security is usually always visible in the hallway. They come down when we have psych patients, which is all the time.

 

[45408]

Most patients stop recording when I ask, but I've had one that refused to stop recording. I told them Georgia law allows one to record with only one party knowing about it, but it's illegal to record a conversation if the other party objects. They quickly stopped recording after that.

I don't know Georgia law, but I do know that in most of the country, as long as you are in a public place, it doesn't matter who is objecting to being recorded. I can walk up and down the street and make a video of anyone. I cannot make videos in places where people "have a reasonable expectation of privacy" (bathroom, locker room, etc) or on private property. The hospital can have a policy that recordings are not allowed, and *voila* no recordings allowed.

 

[alreadylernd]

I don't know Georgia law, but I do know that in most of the country, as long as you are in a public place, it doesn't matter who is objecting to being recorded. I can walk up and down the street and make a video of anyone. I cannot make videos in places where people "have a reasonable expectation of privacy" (bathroom, locker room, etc) or on private property. The hospital can have a policy that recordings are not allowed, and *voila* no recordings allowed.

Wouldn't a patient exam room qualify as a place where people have a reasonable expectation of privacy?

 

[45408]

Wouldn't a patient exam room qualify as a place where people have a reasonable expectation of privacy?

Of course, but that's a moot point when you're recording yourself or allowing your spouse to record you.

 

[wholeheartedly]

Of course, but that's a moot point when you're recording yourself or allowing your spouse to record you.

My understanding is the catch to the reasonable expectation of privacy rule for video is that if the video records audio the audio falls under the so called wiretapping laws so in a state where only one party has to consent, and that can be the recording party, you'd be fine. However, if you're in a state that requires consent of everyone to record audio and you video with audio recording you can get in trouble.

 

[southerndoc]

Of course, but that's a moot point when you're recording yourself or allowing your spouse to record you.

A public place does not include a privately owned hospital even if it received public funding.

 

[45408]

A public place does not include a privately owned hospital even if it received public funding.

Yes, which is why the second half of the sentence said "...or on private property."

 

[caianya]

Don't your hospitals' legal departments provide guidance on this? Or can you ask them to?

Personally, I think it's a bad idea to try to do legal research without a Westlaw or Lexis Law account. And someone who passed a Bar exam doing the research for you. But I'm paranoid like that.

 

[Guero]

This is such an interesting discussion, especially since the advent and surge in facebook, twitter, and the plethora of other social media. My institution and the VA both provide policies on the matter: "'Photography' [includes video, etc] may be disallowed or discontinued at the discretion of the responsible health care provider when it may interfere with patient care and/or is in the interest of patient safety, treatment, and/or healthcare operations and compliance." -my inst

The VA provides annual privacy training that advises providers of basically the same thing as above, but also orders providers to instruct the pts and family to always ask before recording if anyone else aside from the pt and family are in the room. It also says that the provider may ask the pt/family to delete any pictures taken of the provider herself/himself.

Nevertheless, aside from the VA with its annual training, I really had to sift through a bunch of BS to find that sentence; and even then it's legally vague. I'd love to hear something from an MD/JD resident or attending...

 

[caianya]

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