JMIR Publications

ABSTRACT

Background:

Many patients choose to audio-record their medical consultations so that they can re-listen to them at home and share them with family. Consultation audio-recordings can improve patients’ recall and understanding of medical information, and increase their involvement in decision-making. A hospital-endorsed consultation audio-recording mobile app would provide patients with permission and a means to audio-record their consultations. The Theory of Planned Behaviour provides a framework for understanding how patients can be encouraged to appropriately audio-record consultations.

Objective:

The aim of this study was to use a co-design process to develop a consultation audio-recording mobile app called ‘SecondEars’.

Methods:

App development began with stakeholder engagement, followed by a series of 6 co-design workshops, and then user acceptance testing. Stakeholder engagement included advice from: legal; IT; clinical and allied health leads; digital strategy; and medical records. The co-design workshops were attended by: patient consumers; members of the research team; representatives from IT; the app designers; clinicians; and medical records. During workshops 1 to 4 the purpose and scope of the app was refined, possible pitfalls were addressed, and design features were discussed. The app designers then incorporated the results from these workshops to produce a Wireframe mock-up of the proposed SecondEars app which was presented for feedback at workshops 5-6.

Results:

The stakeholders identified 6 requirements for the app, including that it be: patient-driven, secure, clear in terms of legal responsibilities, linked to the patient’s medical record, and that it require minimal upfront and ongoing resources. These requirements informed the scope of the co-design workshops. The workshops were attended by between 4 and 13 people. The workshops attendees developed a list of required features and suggestions for user interface design. The app developers used these requirements and recommendations to develop a prototype of the SecondEars app in iOS, which was then refined through user acceptance testing.

Conclusions:

The SecondEars app allows patients to have control and autonomy over audio-recording and sharing their consultations, whilst maintaining privacy and safety for medical information and legal protection for clinicians. The app has been designed to have low up-keep and minimal impact on clinical processes. The SecondEars prototype is currently being tested with patients in a clinical setting.