This proposal aims to test the feasibility of a software application for the collection, analysis, and reporting of audio-recorded provider-patient conversations. The proposed application makes it possible to efficiently collect and use provider-patient communication data for evaluation and quality improvement. In order to assess the provider-patient communication aspect of care delivery, whether for reimbursement or training purposes, and to fully understand the factors that affect patient outcomes, data are needed that measure real- life (not simulated) provider communication behavior. Additionally, to be accurately evaluated, these data need to be based on direct capture of communication at the point of service (during the encounter), not second-hand through post-visit notes or medical records. In the last ten years, a significant push has been made to measure the quality of communication. Though insightful, the work has been limited by the difficulty of collecting and evaluating real-life communication data in a structured way. The technology for recording conversations is cumbersome and time consuming, and it requires expertise not found in most clinical settings. Furthermore, with the absence of off-the-shelf tools for evaluating the recordings, analysis of communication data which is captured is also cumbersome and open to wide subjectivity. The proposed application, RECAP (Routine Encounter Capture and Analysis Program), addresses this condition. RECAP consists of two integrated tools: 1) a smartphone-based audio capture and delivery application, and 2) a web-based audio analysis and reporting application. Using RECAP, providers will be able to easily and securely audio record patient encounters, with resulting recordings being automatically uploaded to a central location where the content of the recordings can be analyzed. Data generated from analysis can then be used to report individual provider results for evaluation and training purposes or aggregate results for evaluation of provider groups or for research related to provider-patient interaction. The key innovation of the proposed product is that it provides a seamless and easy process for the collection, analysis, and reporting of these data. If successful, it will facilitate much greater activity to analyze and improve provider-patient communication. Phase I includes two aims: 1) develop a smartphone-based audio recording and delivery application paired with a web-based audio analysis and reporting application, and 2) evaluate usability and acceptability of the applications for recording encounters in a clinical setting and for evaluating and reporting on provider communication skills. In Phase II, we will expand application functionality with additional platform compatibility and additional functionality;test effectiveness and cost effectiveness compared to alternative methods;and, further develop commercialization strategies. In Phase III, we will license the product to users and integrators, carry out additiona application improvements, and expand features to make RECAP applicable to other industries.
High quality patient-provider communication leads to greater patient satisfaction and behavior change. The capture and analysis of real-world patient-provider encounters is crucial to assessing the quality of communication and delivering interventions to improve this aspect of care. A secure, structured system that facilitates the routine capture and analysis of patient-provider communication is of great public health importance.