Use of BYODs on patients cause privacy concerns

April 15, 2015 |

The Age in Figure 1: ‘Instagram for doctors’ offers medical ‘porn’ for the public reports on a fairly common practice engaged in by some members of the medical profession, the use of photographic devices to record some of their handiwork or unusual cases.  It is easy enough to do with a smart phone and any number of other portable Bring Your Own Devices such as Ipads.  Hospitals generally have a poor BYOD policies and poor implementation of what policies are in place.  Doctors taking their own devices into an operating theatre or emergency department is, anecdotally, quite a common practice.  While Figure 1 appears to protect the privacy of patients by anonymising the image the problem from a privacy perspective is more fundamental.  If the doctors are taking a photo of a patient in their care or who is within their camera range if they take a photo without consent there maybe a breach of the Privacy Act (Cth) or the Health Records Act (Vic).  Using the photos for a secondary purpose is almost certainly a breach of those Acts. And sending the photos for amusement or even eduction of others is hardly a primary purpose for collection.

The article provides:

 A new wave of apps dubbed ‘Instagram for doctors’ is making it easier for medical professionals to capture and share images of their patients’ most fascinating and perplexing ailments with their colleagues.
But as apps such as Figure 1 grow in popularity, unwitting patients risk becoming the freak show of the internet age.The allure of grotesque medical pictures has piqued the curiosity of the general public. Anyone can freely browse the medical images uploaded by doctors around the world, suggesting the built-in security measures designed to protect patient identity might not go far enough.
Up to 85 per cent of Australian doctors use their personal electronic devices to capture medical images, according to a recent study. It means many doctors leave their clinics or hospitals at the end of the day with potentially sensitive information in their pockets.
But medical imaging app developers say their platforms were specifically designed to protect patient privacy and help doctors avoid fines for publishing patient information under the Privacy Act. 

Launched in Canada in 2013, Figure 1 automatically blurs patient faces and allows doctors to blot out identifiable markings like scars or tattoos.

Doctors can supposedly securely share medical images and crowd source advice or just amuse their colleagues between appointments without breaching privacy laws.

The app has amassed a massive database of images compiled by its users and sorted them into categories where they can be browsed and searched much like you would do on Instagram or Twitter.

Doctors can also “favourite” and comment on cases, offering advice on possible diagnoses, or share the images via email, SMS, Facebook or Twitter.

But so can anyone else. There are no safeguards to stop individuals with no medical qualifications accessing the images hosted on Figure 1.

The app may protect a patient’s identity, but it doesn’t prevent the image being viewed by anyone with a smartphone.

When they consented to their doctor taking a photograph of their weeping foot ulcer, the coin stuck in their oesophagus, or the tumour protruding from their abdomen, did they understand that the image would bounce around the world, readily available to anyone with a penchant for medical porn?

Australia’s peak medical body, the Australian Medical Association last year called on state and territory health departments to develop secure platforms to safely and effectively allows doctors to integrate clinical images into patient records.

In November, the AMA launched a guide to help doctors comply with privacy laws when taking, storing and sending clinical images on their personal smart devices.

The guide instructs doctors to only take photographs when necessary and to obtain patient consent.

“Sharing clinical images is extremely valuable for teaching, research, and advice — but there are also associated legal, professional, and ethical responsibilities,” said AMA president Associate Professor Brian Owler.

“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,” he said.

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