Patient Perceptions of Audio and Video Recording in the Operating Room

Ann Surg. 2021 Jan 15. doi: 10.1097/SLA.0000000000004759. Online ahead of print.

Abstract

Background data: Continuous audio-video recording of the operating room (OR), akin to the aviation industry's black box, has been proposed as a means to enhance training, supplement the medical record, and allow large-scale analysis of surgical performance and safety. These recordings would include patients' bodies; yet, understanding of patient perceptions regarding such technology is limited.

Objective: The goal of this study was to determine surgical patients' perceptions of hypothetical continuous audio-video OR recording (ORR).

Methods: Semi-structured interviews were conducted during elective surgery pre-operative appointments during a two-week period in August 2018 at a quaternary care center. Deidentified transcripts were analyzed using thematic analysis.

Results: Forty-nine subjects were interviewed. Subjects recognized the potential for recording to improve surgical quality, safety and training. Subjects also desired access to an objective record of their own surgery, for the purposes of future care, medical-legal evidence, and to satisfy their own curiosity and understanding. Subjects had mixed perceptions regarding OR decorum and thus, differing views on the potential effect of ORR on OR behavior; some imagined that ORR would discourage bad behavior and others worried that it would cause unnecessary anxiety to the surgical team.

Conclusions: Patients have a diverse set of views about the potential benefits, risks, and uses for OR data and consider themselves to be important stakeholders. Our study identifies pathways and potential challenges to implementation of continuous audio/video recording in operating rooms.