Guidelines for taking clinical images on personal devices

The Australian Medical Association has released a guide for doctors and medical students in the proper use of personal devices such as smartphones when taking and transmitting clinical images.

The guide, Clinical Images and the Use of Personal Mobile Devices, was developed jointly by the AMA and the Medical Indemnity Insurance Association of Australia (MIIAA).

AMA president Brian Owler said the guide outlines the key ethical and legal issues that doctors need to be aware of before using a personal mobile device to take or transmit clinical images.

“These images form part of a patient's medical record, so are subject to the same privacy and confidentiality principles as the rest of the record,” Professor Owler said.

“The guide outlines the professionally appropriate processes of informed consent, documentation, capture, secure storage, disclosure, transmission, and deletion of clinical images, including de-identification and privacy legislation.”

In a study published in the open access Journal of Mobile Technology in Medicine recently, a team led by plastic surgeon David Hunter-Smith, co-developer of the PicSafe Medi application, found that 65 per cent of doctors admitted to taking medical images on their smartphones but only a quarter gained the appropriate consent.

The study also found that of those who took medical images, 64 per cent stored them personally and 82 per cent shared them with someone else.

This practice can run counter to many public hospital policies, which state that clinical images must be de-identified if shared, must be added to the medical record and must not remain on personal devices. They must also be securely stored as part of the medical record for a certain number of years.

The study found that 43 per cent of doctors were aware that an institutional policy existed, but only 28 per cent had read the policy.

PicSafe Medi is one of a number of apps that are now available to allow doctors to take and share clinical images on their devices appropriately. PicSafe Medi itself is currently being trialled in a number of Victorian hospitals as it allows an image to be uploaded to a secure cloud where is can be shared, and then removed from the device.

PicSafe Medi is also available for use by specialists and GPs, particularly for sharing dermatological images.

Acute care software specialist Verdi offers V-Photo, which allows clinicians to take a digital image and upload it straight to the patient record, while in the primary care setting, MedicalDirector offers the Image Safe app from Health v2 through its Widget Store.

Image Safe runs on any iOS and Android mobile device and allows users to take a photo of an area of concern. The image is then sent to Image Safe's server in the cloud and then directly integrated into the patient's file within MD.

There is also a free app called Figure 1 that has been dubbed “Instagram for doctors”, a popular app in the US and Canada that allows doctors to upload images to the cloud to ask for advice. However, this app does not contain the ability to remove the image from the device automatically or to attach it to a medical record.

The AMA-MIIAA guide to clinical images and the use of personal mobile devices is available from the AMA website.

Posted in Australian eHealth

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