The Moscow Health Department began audio recording conversations between doctors and patients. Scanned copies of department order No. 1241 dated December 20, 2023 were distributed by specialized telegram channels. The document states that audio monitoring of outpatient appointments is planned in all state urban medical organizations, except dentists.
The main motivation is to increase population satisfaction with the quality of medical services. The appendix to the order describes algorithms for communicating with patients, and also contains a list of recommended and not recommended expressions. For example, it is proposed to “ask the patient questions in a form that is understandable to him,” “if necessary, explain what was said,” and “inform the patient of the importance of carrying out the full scope of diagnostic, treatment and rehabilitation measures.” In this case, it is necessary to avoid demonstrating superiority, banter, ridicule, and using complex professional terminology that emphasizes the patient’s incompetence in medical matters; provoking and destructive phrases (“girl”, “woman”, “young man”, “it won’t work”, “no, it’s impossible”, “your problem”, “impossible”).
According to media reports, the necessary software has already been installed on the work computers of health workers, and conversations began to be recorded at the end of last year. Presumably, the content of conversations will be analyzed using artificial intelligence. However, there is no information about guarantees of medical confidentiality and how this information is protected from access by third parties. It is not clear from the order whether doctors should ask patients for consent to the audio recording and its further use.
|According to Federal Law No. 323-FZ dated 11/21/2011 “On the basics of protecting the health of citizens in the Russian Federation”, disclosure of information constituting medical confidentiality to other citizens, including officials, is permitted with the written consent of the citizen or his legal representative. Such consent may be expressed in voluntary informed consent. Without consent, information constituting medical confidentiality can be transmitted only in a limited number of cases. Under what conditions is it permissible for a doctor to be photographed by a patient, “MV” was discussed here.
In 2000, the Public Council for the Protection of Patients’ Rights under Roszdravnadzor declared it acceptable to make audio and video recordings in areas of medical institutions critical to patient risk, such as the emergency department, operating room, intensive care unit, and maternity ward. First of all, in order to control the timeliness of providing medical care to the patient, the president of the NP “National Agency for Patient Safety and Independent Medical Expertise”, adviser to the medical insurance organization “Capital-MS” explained to MV. . It was assumed that only representatives of Roszdranadzor could have access to the part of the recording of interest at the request of law enforcement agencies, courts or insurance companies.
From the point of view of the law, there is nothing reprehensible in the actions of the capital’s officials, he explained. “Recording tools are primarily a means of preventing violations of patients’ rights. The main thing is that only a small circle of officials have access to the records. My point of view is that cameras are necessary, but it is important that they are not props. Otherwise, there will be no result: in the event of a conflict, the patient will not achieve anything, and the records will be used to eliminate and punish doctors,” says Starchenko.
“MV” sent a request to the Moscow Department of Health with a request to confirm the authenticity of the document and explainhow and with what frequency audio monitoring will be carried out; whether patients will be informed about it; and how the safety of medical confidentiality will be ensured, taking into account the access to audio information of the inspection persons.
By organizing such audio control, clinics take on additional responsibility for the safety of citizens’ personal information, noted the co-chairman of the All-Russian Patients’ Union Yuri Zhulev. “The very fact of keeping a record will motivate not only doctors, but also patients to behave correctly. It is possible that these recordings can be used as evidence in court. My attitude towards this is positive,” he told MV.