Table 1.

The requirements of the app identified through stakeholder engagement.

Requirement	Description of requirement	Suggested means to meet the requirement
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