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.

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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    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.



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