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Guide on using mobiles to capture and share clinical images

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Any junior or senior doctor can tell you that clinical images are routinely captured and used by doctors, every day and in every ward, in the course of caring for their patients.

But, in doing so, are doctors and medical students meeting their significant legal, professional and ethical responsibilities?

In response to this uncertainty, the AMA has collaborated with the Medical Indemnity Insurance Association of Australia to develop guidelines covering the key issues that doctors must consider before capturing and transmitting images on personal mobile devices like smart phones.

There’s no doubt that images are valuable for capturing clinical signs, injuries and lesions, and monitoring of these over time.

Appropriate transmission of clinical images aids professional referrals for improved diagnosis, treatment and management, particularly in regional, rural and remote settings, where specialist services may be limited or not available.

Clinical images may also be used for non-clinical purposes, such as teaching, training and research.

However, there is concern that clinicians have inadequate understanding of their significant legal, professional and ethical obligations regarding the use of clinical images. To date, there have been no clear national professional guidelines to guide clinicians in meeting their responsibilities.

Many doctors do not realise that an image, even if captured on a personal mobile device, forms part of a patient’s medical record, and is subject to the same privacy and confidentiality principles as any other element of the record.

Additional complexities that arise from the capture of images on personal mobile devices, such as ensuring adequate quality, managing automatic cloud backups and the recording of metadata such as image location, can prove difficult for clinicians to navigate.

Under the new Australian Privacy Principles, revised in early 2014, there are significant legal penalties for breaches in confidentiality of medical records, in addition to a clinician’s professional and ethical obligations.

Clinical Images and the Use of Personal Mobile Devices: A Guide for Doctors and Medical Students outlines professionally appropriate processes of informed consent, documentation, capture, secure storage, disclosure, transmission and deletion of clinical images, including considerations of quality, de-identification and privacy legislation. Case reports and discussion of complex situations are included, as is a simple flow-chart, summary and checklist for busy clinicians.

Despite the existence of clinical imaging departments in many hospitals, pragmatic clinicians who capture images using personal mobile devices often find it difficult to integrate these images into the medical record.

Alongside release of this guide for clinicians, the AMA will be advocating for health services to improve systems for the secure uploading of images into patients’ records.

The guide, released on 21 November, has been developed through collaboration between the AMA Council of Doctors-in-Training and the Medical Indemnity Insurers’ Association of Australia, and is a must-read for doctors and medical students who capture clinical images in Australian hospitals.

For further information, and to download a copy of Clinical Images and the Use of Personal Mobile Devices: A Guide for Doctors and Medical Students, visit the AMA website: www.ama.com.au