1. Patient-driven |
The app should be used by patients, not hospital staff; If the patient’s clinician has given permission to be audio-recorded, the patient should have ultimate control over when and how the patient uses the app; This is not only important in terms of patient participation but also for practicality and financial feasibility of the app (see requirement 5) |
The patient must be able to source, download, and use the app independently, with minimal input from hospital staff |
2. Secure |
The audio-recordings saved on the app and shared from the app must be secure as they will contain identifiable information |
Access to recordings should be given only to users of the system via Secure Sockets Layer; The actual recording files should never be sent via unsecure means (eg, short message service, email); Strong password policy for Admin access |
3. Linked to medical record |
Consultation audio-recordings should be considered a part of the patient’s medical record; Saving original copies of the audio-recordings on the patient’s medical record may help guard against tampering or misrepresentation in the case of a malpractice lawsuit |
An original copy of all audio-recordings made on the app should be stored in the appropriate patient’s electronic medical record, or in a secure location that is accessible by medical record staff |
4. Clear legal responsibilities |
Patients using the app must be aware that they are legally responsible for the safety of the audio-recordings that are saved on and shared from their mobile, just as they are responsible for any copy that they are given of any component of their medical record |
Include statement of responsibility on the opening screen of the app and in all app promotion material |
5. Minimal upkeep |
Once developed and implemented into usual care, the app should require minimal input from the staff and minimal ongoing financial costs |
Integrate the app into existing hospital procedures; Automate processes where possible (eg, automatic upload of recordings from the app to the medical record); Use the latest secure cloud infrastructure to keep ongoing costs down |
6. Minimal upfront costs |
Additional funding could not be sought until the app had been piloted in a clinical setting and evidence was obtained about the usability of the app, whether it met requirements 1 to 5, and the extent of uptake among patients |
Develop a minimal viable product. Results of the pilot can then be used to refine the product and support further, ongoing funding; Develop in iOS only (not Android); Delay investing in automating processes until after piloting |