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Beware risks of using smartphones for clinical photos

MDU warns doctors against sharing photos through apps or online

Louise Prime

Friday, 28 June 2013

Doctors must take extreme care over taking photographs and recordings of patients because of the pitfalls of modern technology, the Medical Defence Union has warned this week. The MDU is concerned that doctors could become particularly vulnerable to patient complaints if they use the latest photo-sharing apps or websites to share clinical cases with colleagues.

Members have recently asked the MDU about whether they could share, online, photographs of rare or interesting conditions to elicit medical colleagues’ opinions; whether they could use clinical images for teaching purposes; and how to protect patient confidentiality in television documentaries. In some cases, patients have made complaints after their doctors had taken photographs or made recordings.

The MDU’s head of advisory services Dr Mike Devlin said: “There are many circumstances where doctors feel it may be beneficial to take a photograph of a patient’s clinical signs or record a consultation. However, it is important that they have the patient’s informed consent before doing so and they must follow GMC guidance on making and using visual and audio recordings of patients … The onus is on the doctor to find out if there are any relevant [trust] policies.”

He urged special caution when photographing a patient with a smart phone or digital device on which the photos are stored, especially if the device is connected to the internet. He advised: “[The photograph] will need to be protected in the same way as would apply to other clinical records or recordings. We advise that such devices used for this purpose are encrypted and if they are not, that the images are immediately downloaded to a device that is and the original image permanently deleted.

“The temptation may be to make use of popular or more niche file sharing apps and websites, in order to share photographs with medical colleagues. Although sharing photos in this way may seem like a useful way to gain opinion or discuss medical conditions with like-minded medical professionals, it comes with many risks which are likely to outweigh the benefits.” He added that any doctor considering sharing photos online should discuss the specific case, in advance, with their defence organisation.

The MDU’s latest advice about photographing or recording patients includes:

  • When seeking specific consent to record patients as part of their care, explain why it is needed, how it may be used and stored. Covert recording is rarely justified and can only be considered with specific authorisation and in line with the law.
  • If you wish to use an image or recording in anonymised form for teaching, research or other healthcare purposes, this must be explained to patients and their specific consent obtained, making a note of the discussion in the patient’s records. Exceptions may apply in some cases, such as X-rays or pathology slides.
  • If an image made using a mobile phone or tablet computer should ever fall into the wrong hands it is unlikely that you will be able to argue that you had taken all reasonable steps to protect its security given it contains confidential patient information. Such devices should be protected with encryption software, and you must make sure your settings do not allow images to be uploaded to the internet automatically through photo sharing apps and websites.

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