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Devices Assembled to Record Doctor-Patient Interactions

Nadir Weibel

Nadir Weibel (Univ of California, San Diego)

13 February 2015. Computer scientists at University of California in San Diego assembled a collection of audio and video devices into a portable package that records doctors’ consultations with patients when also using electronic health records. The team led by computer science researcher Nadir Weibel that includes members from San Diego university and veterans’ medical centers, published its first report on the package in this month’s issue of the journal Personal and Ubiquitous Computing (paid subscription required).

The package of electronics, called Lab-in-a-Box, has sensors, microphones, and video camera with associated software designed to capture the multiple dimensions in interactions between a doctor during consultations with a patient. Collecting the full richness of these interactions is becoming more important, given the amount of attention needed by doctors in recording information into electronic health records.

“With the heavy demand that current medical records put on the physician, doctors look at the screen instead of looking at their patients,” says Weibel in a university statement. “Important clues such as facial expression, and direct eye-contact between patient and physician are therefore lost.”

Lab-in-a-Box hardware tracks the doctor’s computer activity, speech interactions, visual attention, and body movements. The equipment includes an eye tracker that follows where the doctor is looking, a 360-degree microphone recording audio in the room, a depth camera from a Microsoft Kinect device recording body and head movements, and sensors tracking keyboard strokes, mouse movements, and pop-up menus on the doctor’s computer. The system’s software merges and sequences the different data streams to highlight activities that could indicate distractions from the patient caused by attention to the computer.

Lab-in-a-Box is part of a larger assessment of medical records usability in clinical workflows, funded by the U.S. Agency for Healthcare Research and Quality, and led by UC-San Diego medical professor Zia Agha, the journal paper’s senior author. The package is being field tested at UC-San Diego Medical Center and the San Diego Veterans Affairs Medical Center. The team plans to analyze interactions to uncover systematic differences across various specialties and settings.

The journal article offers an early snapshot of the system at work. Lab-in-a-Box, say the authors, has the potential to uncover valuable insights into the interactions between patient, doctor, and electronic health records, leading to improvements in the design of software to reduce doctors’ distractions from patients during consultations. The system could also provide real-time feedback to doctors on their level of attention to the patient.

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