As a Moore Foundation early-career investigator in patient and family engagement, Paul Barr, assistant professor at the Dartmouth Institute, is developing a platform to allow for routine audio recordings of conversations between clinicians and patients.
The Open Recording Automated Logging System, (ORALS) system will be designed to tag recordings and enable patients and their family members to easily access the information that is important to them.
In this installment of Beyond the Lab, Paul discusses why he believes enabling patients to easily access recordings of their doctor’s visits will strengthen patient/provider communication and ultimately improve health outcomes.
What inspired you to become a scientist/researcher?
I think above all I was influenced by my mum. When she was young, she trained to be a nurse, but she couldn't finish her training due to a skin allergy. The material they were using in surgeries at the time gave her a severe reaction, so, unfortunately, she had to drop out of training. She then went on to have seven children in nine years.
After she raised all of us, she began working as a care assistant. She was basically doing the job of a nurse, just without the qualification. I finally said to her, “Mum, seriously, just go back to university and get your nursing degree. You've always wanted to do that.” She did end up going back, and now she's the manager of a nursing unit in the U.K. That’s pretty impressive, from anyone’s standpoint, and it’s always been an inspiration to me personally.
What topics/areas/problems in science are you most interested in solving?
I'm very interested in the primary care setting. I think it's the place where most people initially seek help, and I think it's the place where you can foster the highest level of patient engagement. For folks with chronic conditions, for example, that's where most of the work managing their conditions is done. So, when you think about communicating information, sharing decisions, engaging someone in a conversation, from my perspective, primary care is really the place where we need to start to make sure that's happening.
One of the ways I think we can improve communication at the primary care level is through audio recordings. We know from our work that patients greatly value the opportunity to listen back to a recording of a clinical visit. They can use it to help them understand and recall information. They also can share it with a family member to better engage them in their care.
My goal is to develop a system that would allow patients to securely record and access audio recordings of clinical visits. It also would automatically highlight the key points of the visit for them. I’m working with colleagues at the IC3D lab here at Dartmouth and with medical investigators Amar Das and Saeed Hassanpour—experts in natural language process and machine-learning techniques. We are using machine-learning methods to automate the identification of the key parts of the clinic visit. The way the system would work is that once a recording of the visit is made, it’s then uploaded to our software, which can then essentially review the clinic visit and identify which segments are important. These key parts would then be tagged and highlighted. A patient or caregiver could then just click on that recording, for example, to listen to the diagnosis, the treatment plan, or the referral. It's easy to access and navigate, and I think it will be an important tool in helping people manage their health.
How do your colleagues, mentors, students/postdocs help you achieve your goals?
When I first came to Dartmouth, I joined the Preference Laboratory. It's a research group started by Glyn Elwyn, who is known for his work in shared decision making. We’re pursuing an ambitious research agenda of patient engagement in all different areas. It’s been enormously helpful to have that type of experience, expertise, and diversity of interests at my disposal. It’s given me a very solid framework to pursue my own goals as a researcher.
I also work with a group of medical and undergraduate students who are interested in getting involved in research. They bring interest, enthusiasm and fresh insights; collaborating with them has been a real joy.
What gets you going every day (besides coffee) and how do you stay motivated?
It’s very disturbing to me on a personal level to see people who don’t have a voice or who are left by the wayside of the healthcare system. I really want to make some difference to those who need support and are not getting it.
Another thing that keeps me motivated is just the reality that here in the U.S., you have to get grants in the door to support your work. It drives you to work hard to make that happen because without this funding you're unable to support your own researchers and research agenda.
What are your greatest limitations/challenges as a scientist/researcher?
I don't know if it's a limitation as such, but something I am very aware of is the fact that I have a specific skillset, and I only know a fraction of what I need to know. As a result, I’m always cognizant of my limitations and am always striving to collaborate with people who are experts in other disciplines, such as machine learning and natural language processing.
I also am always striving to hit that perfect balance between my family, who are my first priority, and my dedication to my work. I try not to check emails after seven p.m. or to work on weekends. I think you need to try to get that balance right because we get burnt out so quickly. That is a challenge for any academic. I just hope that I have done it right for my family, and for my career, and that I can continue this balancing act.
Learn more about Open Recordings here, and follow Paul on Twitter here.
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