FAQ

Record your clinical and technical conversations with your patient. You and your team are in complete control over when and how to use DAN, and you do need the patient's consent to start a recording. Teams that are confident using DAN seamlessly introduce and start DAN as the clinical discussion starts. They may start and stop DAN at various points throughout the appointment, or leave it running.

Introduce DAN just as you start your clinical conversation. Your reception and nursing staff have made the patient feel comfortable, the patient is sitting in the chair, and its time to talk your passion - dentistry. Try this:

1. DAN: press record and enter the patient id (copied from your practice management system)
2. Introduce DAN and gain consent. Here are some examples:
• Dentist:
  

  "We are going to have an important conversation. May we record it to form part of your patient record?"

• Dentist:
  

  "We are going to have a really in-depth conversation about your oral health. Do you mind if we record it so we capture it all in a record that we can share with you? It will form part of your clinical dental record."

• Dentist:
  

  "We are really interested in making each aspect of our practice as good as we can, so for our record keeping, we use technology to help us make a complete, accurate and contemporaneous record. Are you happy for us to make a secure audio recording of your appointment? It will form part of your clinical dental record."

• Dentist:
  

  "We are going to have a conversation about this tooth because you have lots of options available to you. [Becky] is really fast at typing, but it's hard for her to write absolutely everything, so would you mind if we made an audio recording of our conversation that will form part of your clinical dental record?"

3. Patient: yes/no
4. DAN: Confirm or decline consent. Enter 'recorded in DAN' in your written record.

If you confirm the patient's consent, then the recording continues until you press stop. In addition, you will have the patient's verbal consent to the recording, recorded and marked in DAN avoiding any paperwork.

If consent is not granted, the recording is stopped and the few seconds of audio recorded thus far is destroyed.

Yes they do, and recordings are managed accordingly. Recordings are retained for the same period as any other clinical record, as defined by the relevant governing bodies, currently 11 years, or until 25 for minors.

Once a recording has been made, it forms part of the patient record, so it cannot be edited or removed, the same way in which a written dental record cannot be adjusted or deleted. If consent is revoked for a recording, this is easy to apply to a patient's recordings. Recordings without consent cannot be played. Records are automatically removed after the retention period defined by the relevant governing bodies, currently 11 years, or until 25 for minors. There are options available if you keep clinical records for longer than this.

Security

• Only you, and users you authorise, can decrypt audio and text annotation data. The Dental Audio Notes team has no way of decrypting this data.
• Data is always encrypted in transit using HTTPS/TLS.
• Data in our servers are encrypted using AES-256 encryption, securing data at rest.
• All data is stored in the UK, no data ever leaves the UK.

Data is uniquely encrypted at source. That means that recorded audio, patient identifiers and text notes are encrypted immediately with unique keys on your machine running DAN. Data is decrypted locally only at the moment it is required. This means that decrypted data is only available to authenticated and approved users, or via a one-time share link. We cannot decrypt your data.

Dental Audio Notes is fully compliant with the NHS DSP (Data Security and Protection) Toolkit (8KM26) and GDPR. Independent experts security test our systems regularly and all recommendations are implemented.

Privacy

Privacy is core to everything we do at Dental Audio Notes. We are fully transparent about how we, as a data processor, use the data you share with us. Our Privacy Policy and Governance Overview which provides our guarantees to you as a data controller, provides you with this information. We also have an example DPIA to support your impementation of DAN. You are welcome to refer to these documents when updating your practice policy.

DAN operates alongside, and independent of, your practice management system. DAN seamlessly manages all the storage, security, reliability and accessibility for you, whilst being super-lightweight on your team, processes and IT infrastructure.

A recording is linked to your patient by the patient code or Reference ID from your practice management system when you start a recording, a manual task which takes seconds. It is good practice to note that a recording has been made in your written records. This can be as simple as: "recorded in DAN". You can easily access this recording by searching by the patient identifier you use.

Running DAN alongside your practice management system is fast, robust and secure. It is featherlight on your existing systems protecting your existing servers from being overloaded by large files. It is a mammouth task to securely, privately and reliably create, store and access audio recordings quickly and seamlessly. This is the task DAN specialises in.

With a reasonable microphone you can make audio that you can clearly listen back to from almost any surgery environment. The greatest influence on the quality of your audio is the microphone, and we have a blog article going into depth on this. We have had excellent results with the Yeti microphone from Blue.

Indemnity providers are rarely in the position to endorse or comment on the suitability of a product, but will provide advice and considerations when making audio recordings of patient consultations. You should reach out to your indemnity provider for an official response. The key points, and how DAN satisfies these points are:

Dental professionals who record consultations need to obtain consent before any recording is made. Patients need to understand the following: Who will be allowed to see it? In what context it will be used? Whether copies will be made and the arrangements for secure storage? How long it will be kept?

Consent is documented when a recording starts and is required to save the recording. Best practice is to audibly confirm consent with the patient the moment after pressing record. Patients should be reassured that they can refuse or withdraw their consent at any point, and this is really easy for you to apply. Only you and users you authorize have access to the audio. The audio context is the same as patient records, and is stored accordingly. All data is fully encrypted throughout its lifecycle and copies are only made when a download link you have shared is activated.

Once a recording has been made, it will form part of the patient records. Patients are not be able to insist on deletion at this stage in a similar way that a patient would not be entitled to have a written dental record adjusted or deleted. If any patient wishes to change any part of the recording, this would not be allowed. Should any patient raise a concern about the contents, you would have to make a note of their concern in the written record rather than attempt to delete or edit any part of the recording.

Audio cannot be edited in DAN. Audio is only deleted when it reaches the end of its retention period.

Patients are entitled access to their recording as they are with other forms of patient record.

Providing a copy to patients takes 30 seconds by sharing a secure download link. The audio is cryptographically signed so we know if a recording matches the original.

Making a recording does not replace the need to make a thorough clinical record of the consultation and any decisions that were made on the treatment or diagnosis, the recording could be seen as an adjunct to the records rather than as a replacement for them.

Your written records can focus on clinical factors and decisions, for you to quickly absorb before your patient's next visit. DAN provides a complete, accurate and immediate record of your conversation with all its context.

You may wish to consider a practice policy on the above which details how recordings will be stored, who will have access to recordings etc.