Medical photography with a mobile phone: useful techniques, and what neurosurgeons need to know about HIPAA compliance

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Medical photographs are commonly employed to enhance education, research, and patient care throughout the neurosurgical discipline. Current mobile phone camera technology enables surgeons to quickly capture, document, and share a patient scenario with colleagues. Research demonstrates that patients generally view clinical photography favorably, and the practice has become an integral part of healthcare. Neurosurgeons in satellite locations often rely on residents to send photographs of diagnostic imaging studies, neurological examination findings, and postoperative wounds. Images are also frequently obtained for research purposes, teaching and learning operative techniques, lectures and presentations, comparing preoperative and postoperative outcomes, and patient education. However, image quality and technique are highly variable. Capturing and sharing photographs must be accompanied by an awareness of the legal ramifications of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA compliance is straightforward when one is empowered with the knowledge of what constitutes a patient identifier in a photograph. Little has been published to describe means of improving the accuracy and educational value of medical photographs in neurosurgery. Therefore, in this paper, the authors present a brief discussion regarding four easily implemented photography skills every surgeon who uses his or her mobile phone for patient care should know: 1) provide context, 2) use appropriate lighting, 3) use appropriate dimensionality, and 4) manage distracting elements. Details of the HIPAA-related components of mobile phone photographs and patient-protected health information are also included.

ABBREVIATIONS dpi = dots per inch; fps = frames per second; HIPAA = Health Insurance Portability and Accountability Act.

Article Information

Correspondence Rebecca A. Reynolds: Vanderbilt University Medical Center, Nashville, TN. rebecca.a.kasl@vumc.org.

INCLUDE WHEN CITING Published online January 4, 2019; DOI: 10.3171/2018.8.JNS182075.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

© AANS, except where prohibited by US copyright law.

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Figures

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    Postoperative wound photographs with magnified (left) and contextual (right) views. Figure is available in color online only.

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    The 3D nature of bridging veins is illustrated with a perpendicular and parallel light source. Figure is available in color online only.

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    The change in head shape is illustrated in a child with metopic craniosynostosis before (left column) and after (right column) surgical correction with axial (A and B) and coronal (C and D) views. Figure is available in color online only.

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    Surgical specimen with an uncontrolled (upper) and controlled background (lower). Figure is available in color online only.

References

1

Angileri FFCardali SConti ARaffa GTomasello F: Telemedicine-assisted treatment of patients with intracerebral hemorrhage. Neurosurg Focus 32(4):E62012

2

Chalouhi NDressler JAKunkel ESDalyai RJabbour PGonzalez LF: Intravenous tissue plasminogen activator administration in community hospitals facilitated by telestroke service. Neurosurgery 73:6676722013

3

Dadlani RMani SA U JGMohan DRajgopalan NThakar S: The impact of telemedicine in the postoperative care of the neurosurgery patient in an outpatient clinic: a unique perspective of this valuable resource in the developing world—an experience of more than 3000 teleconsultations. World Neurosurg 82:2702832014

4

Demaerschalk BMVargas JEChanner DDNoble BNKiernan TEGleason EA: Smartphone teleradiology application is successfully incorporated into a telestroke network environment. Stroke 43:309831012012

5

Dulou RDagain ADelmas JMLambert EBlondet EGoasguen O: The French mobile neurosurgical unit. Neurosurg Focus 28(5):E132010

6

Haridas RP: Photographs of early ether anesthesia in Boston: the Daguerreotypes of Albert Southworth and Josiah Hawes. Anesthesiology 113:13262010

7

Hibler BPQi QRossi AM: Current state of imaging in dermatology. Semin Cutan Med Surg 35:282016

8

Horbinski CFine JLMedina-Flores RYagi YWiley CA: Telepathology for intraoperative neuropathologic consultations at an academic medical center: a 5-year report. J Neuropathol Exp Neurol 66:7507592007

9

Jillani J: The Harvey Cushing Brain Tumor Registry. The New Yorker. October 2 2014

10

Kreutzer JAkutsu HFahlbusch RBuchfelder MNimsky C: Teleradiology in neurosurgery: experience in 1024 cases. J Telemed Telecare 14:67702008

11

Ling JMLim KZNg WH: Use of multimedia messaging system (MMS) by junior doctors for scan image transmission in neurosurgery. World Neurosurg 77:3843872012

12

Mauer UMKunz U: Management of neurotrauma by surgeons and orthopedists in a military operational setting. Neurosurg Focus 28(5):E102010

13

Means JMKodner IJBrown DRay S: Sharing clinical photographs: Patient rights, professional ethics, and institutional responsibilities. Bull Am Coll Surg 100:17222015

14

Mendez IHill RClarke DKolyvas GWalling S: Robotic long-distance telementoring in neurosurgery. Neurosurgery 56:4344402005

15

Mendez ISong MChiasson PBustamante L: Point-of-care programming for neuromodulation: a feasibility study using remote presence. Neurosurgery 72:991082013

16

Nayler JR: Clinical photography: a guide for the clinician. J Postgrad Med 49:2562622003

17

Pirris SMMonaco EA IIITyler-Kabara EC: Telemedicine through the use of digital cell phone technology in pediatric neurosurgery: a case series. Neurosurgery 66:99910042010

18

Prantl LBrandl DCeballos P: A proposal for updated standards of photographic documentation in aesthetic medicine. Plast Reconstr Surg Glob Open 5:e13892017

19

Shenai MBTubbs RSGuthrie BLCohen-Gadol AA: Virtual interactive presence for real-time, long-distance surgical collaboration during complex microsurgical procedures. J Neurosurg 121:2772842014

20

Shivapathasundram GHeckelmann MSheridan M: Using smart phone video to supplement communication of radiology imaging in a neurosurgical unit: technical note. Neurol Res 34:3183202012

21

Shivji SMetcalfe PKhan ABratu I: Pediatric surgery telehealth: patient and clinician satisfaction. Pediatr Surg Int 27:5235262011

22

Silva GSFarrell SShandra EViswanathan ASchwamm LH: The status of telestroke in the United States: a survey of currently active stroke telemedicine programs. Stroke 43:207820852012

23

Sinha VDTiwari RNKataria R: Telemedicine in neurosurgical emergency: Indian perspective. Asian J Neurosurg 7:75772012

24

Thomale UW: Intracranial ventricular catheter placement with a smartphone assisted instrument. Methods Mol Biol 1256:4054172015

25

Thomale UWKnitter TSchaumann AAhmadi SAZiegler PSchulz M: Smartphone-assisted guide for the placement of ventricular catheters. Childs Nerv Syst 29:1311392013

26

Thomas VARugeley PBLau FH: Digital photograph security: what plastic surgeons need to know. Plast Reconstr Surg 136:112011262015

27

U.S. Department of Health & Human Services: HIPAA for Professionals. HHS.gov. (https://www.hhs.gov/hipaa/for-professionals/index.html) [Accessed September 14 2018]

28

Uzun MBülbül MToker SBeksaç BKara A: Medical photography: principles for orthopedics. J Orthop Surg Res 9:232014

29

Van Hooff RJCambron MVan Dyck RDe Smedt AMoens MEspinoza AV: Prehospital unassisted assessment of stroke severity using telemedicine: a feasibility study. Stroke 44:290729092013

30

Waran VBahuri NFNarayanan VGanesan DKadir KA: Video clip transfer of radiological images using a mobile telephone in emergency neurosurgical consultations (3G Multi-Media Messaging Service). Br J Neurosurg 26:1992012012

31

Wechsler LR: Advantages and limitations of teleneurology. JAMA Neurol 72:3493542015

32

Wirz RTorres LGSwaney PJGilbert HAlterovitz RWebster RJ III: An experimental feasibility study on robotic endonasal telesurgery. Neurosurgery 76:4794842015

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