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Consultation Recordings Support Shared Decision Making in Oncology During COVID-19 Pandemic

Recording patient and oncologist consultations can relieve pandemic-related barriers to shared decision making such as restrictions on the number of caregivers allowed to accompany patients to in-person encounters, psychological stress, and technological issues with telehealth (JCO Oncol Pract. 2020;OP2000765. doi:10.1200/OP.20.00765).

“Randomized clinical trials have demonstrated that recordings increase knowledge, information recall, and decisional self-efficacy for patients with cancer; they also decrease decision regret and anxiety,” wrote Daniel Kwon, MD, Division of Hematology/Oncology, Department of Medicine, University of California (San Francisco, CA) and colleagues. “Recordings allow patients to recall, review, and share information discussed in a clinical encounter.”

Access to consultation recordings can allow patients to recall, review, and share information with their caregivers discussed in the clinical encounter. Stresses of being exposed to SARS-CoV-2 and technology struggles during telehealth consultations are removed, allowing patients to make informed and focused decisions.

However, implementation of recordings has been low due to clinician reluctance, legal and privacy concerns, lack of awareness of the evidence base, and resource costs. The study authors discuss solutions to overcome these problems. For example, patients are asked to sign a service agreement prior to being offered a consultation recording to address privacy, risk, and legal concerns. Costs are addressed by using student interns to prepare recordings.

“Oncologists should engage their information technology, legal, and privacy departments to provide institutionally generated consultation audio recordings,” discussed Dr Kwon and colleagues. “In the meantime, healthcare systems should encourage patients to create their own recordings using their personal devices.”—Lisa Kuhns


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