Attaching large files to records e.g. Video

Modified on Tue, 25 Mar at 1:36 PM

Clinical systems have maximum size limits. Typically 5MB. (NHS National Document Respository lists this as 4.5MB).

Larger files will need to be split or adjusted by other means.

The team most-often receives queries about this regarding video files.

Videos

We do not offer video editing/transcoding training. The following is general guidance and recommendations that assumes this will be managed by a suitable digital/IT representative within the surgery.

The following are three phases to consider if you wish to evidence the events from a video. We recommend the responsible clinician records their clinical observations in writing in all cases; whether or not a video/photo is attached as attachments will not be accessible in all situations that the written record, including that digital file formats can become outdated and even inaccessible.

One: Adjust the video

Take the following measures depending on the context of what you are trying to evidence in the record.

Some of these are supported by software that is included with WIndows such as a the Microsoft Photos app.

Trim/cut: Remove parts that aren't needed - 5 minute video with 20 seconds of seizure? Trim it. -10 minute video with three events? Split/trim to separate short videos.
Reduce the resolution - Is it high resolution (4K/1080p/720p) and is that required to evidence the observation? Would standard definition (or even less) be adequate?
Reduce the framerate - If 60fps, reduce to 30 or 25 (25 & 24 are the TV/movie industry standards)
Remove the video/audio - Is the event the sound? Remove the video and attach the sound recording (or vice versa if only the visual is important and the sound is not required).
Re-encode with a more advanced codec (when available) i.e. Perceived quality stays the same, but file size will be lower

Note: If editing videos/photos for care, ensure the solution is processing the video on the machine. Anything server/web based likely needs a DPIA and your DPO's authorisation.

Clinician records observations in writing based on original/complete video.

Two: Stills/photos instead

Get stills from the video to evidence. e.g. A before/after comparisons.

Clinician records observations in writing based on original/complete video.

Three: Don't attach anything

Clinician records the observations they would if they'd seen the event(s) in person if there were no video/photos, but specifying the observations were from a video that was too large to attach to the record. Medical terminology includes a wealth of options so complex isues/concepts/symptoms can be logged in writing.