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

Restricted access

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

Contributor Notes

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.
Headings
References
  • 1

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

    • Search Google Scholar
    • Export Citation
  • 2

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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 4

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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 11

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

    • Search Google Scholar
    • Export Citation
  • 12

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

    • Search Google Scholar
    • Export Citation
  • 13

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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 18

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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 21

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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 26

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

    • Search Google Scholar
    • Export Citation
  • 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]

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
  • 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

    • Search Google Scholar
    • Export Citation
TrendMD
Metrics

Metrics

All Time Past Year Past 30 Days
Abstract Views 112 112 112
Full Text Views 37 37 37
PDF Downloads 71 71 71
EPUB Downloads 0 0 0
PubMed
Google Scholar