ORALS

Purpose

In partnership with Primary Investigator Paul Barr, the Open Recording Automated Logging System (ORALS) project (www.openrecordings.org), aims to develop and test an interoperable system to facilitate routine recording of patient and family engagement.

Health care consumers now have the ability to make audio recordings of their doctor's appointments. These recordings allow patients to review the content of an encounter and have important information reinforced. Diagnosis, medication information, instructions, and discussion of options are all kinds of information that may be forgotten by the patient. With an audio recording, a patient has a permanent record of this information and can refer to it at any time. Also, many patients have caregivers who need to be informed about the content of a doctor's visit. An audio recording can be shared with one's caregiver so that information that may be too technical or complicated for the patient can be interpreted and reinforced by the caregiver.

The built-in voice recording applications on today's smartphones, however, are not appropriate for the management of audio recordings of doctor's visits. The protected health information in these recordings should not reside on the patient's phone, where loss of the device can mean loss of privacy. Rather, it should be stored on a secure central server so that access to the recordings, by the patient and by caregivers, can be controlled by the patient. The Open Recording Automated Logging System (ORALS) project aims to meet these needs and more. ORALS is both a recording and playback application specifically designed for recordings of patient-doctor encounters. With ORALS, patients can record visits on their phone, have them automatically uploaded to a secure server, and have them automatically removed from the phone itself. ORALS is also a web application with which patients can review, annotate, and organize their recordings. Patients can also manage the access of other people such as caregivers to the recordings.

ORALS does more than just record, manage, and play back audio recordings. Once a patient's recording is uploaded, the audio is automatically transcribed into text. That text is then analyzed using a machine learning algorithm so that key moments in the visit can be highlighted by the playback interface. This makes navigation of the recording much easier. The patient can just tap on a section of the audio that is marked as being about diagnosis, or tap on another section that is marked as being about medication, depending on the type of information that is sought. Further, we plan to extend the ORALS software so that links to trustworthy sources of information on the Web, links specific to what was discussed during the visit, can be added to the recording playback interface.

Our hope is that the ORALS software allows patients to be more informed by, and perhaps more compliant with, the conversations that they have with their healthcare provider. We are still developing the first prototype of the software and plan to be testing it with real patients in early 2018.

ORALS Website:

Intended Audience

• Patients
• Clinicians

Publications and Presentations

Barr PJ, Dannenberg MD, Ganoe CH, Haslett W, Faill R, Hassanpour S, Das A, Arend R, Masel MC, Piper S, Reicher H, Ryan J, Elwyn G. Sharing Annotated Audio Recordings of Clinic Visits With Patients—Development of the Open Recording Automated Logging System (ORALS): Study Protocol. JMIR Res Protoc 2017;6(7):e121. DOI: 10.2196/resprot.7735 PMID: 28684387 PMCID: 5519830

Contact

Supported by a grant from the Gordon and Betty Moore Foundation.