27th January 2017, Volume 130 Number 1449

Monique Jonas, Phillipa Malpas, Kate Kersey, Alan Merry, Warwick Bagg

Technology is developing at a breath-taking pace across social and professional domains, and medical practice is no exception. New technologies create exciting possibilities for providing and documenting care, and for…

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Summary

Technological developments are changing practice in medicine. These changes can be beneficial for patient care, but they can also generate risks. The Faculty of Medical and Health Sciences at the University of Auckland have adopted a policy that clarifies expectations for the way in which healthcare students handle photographic and radiological images of patients. This policy prohibits University of Auckland healthcare students from uploading patient images to image-sharing apps and also sets requirements relating to the use of personal devices to take images of patients for treatment purposes.

Abstract

Aim

To develop a policy governing the taking and sharing of photographic and radiological images by medical students.

Method

The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers’ Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated.

Results

The policy ‘Taking and Sharing Images of Patients’ sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland.

Conclusion

Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

Author Information

Monique Jonas, Senior Lecturer, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Phillipa Malpas, Senior Lecturer, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Kate Kersey, Lecturer, Faculty of Health and Environmental Sciences, AUT, Auckland; Alan Merry, Professor, Head of School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland; Warwick Bagg, Associate-Professor, Head of Medical Progamme, Faculty of Medical and Health Sciences, University of Auckland, Auckland.

Acknowledgements

We would like to thank the anonymous reviewer for their insightful and constructive comments. We also gratefully acknowledge the contribution of students and colleagues within FMHS and within district health boards who have advised and assisted with the writing of the Policy.

Correspondence

Monique Jonas, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland.

Correspondence Email

m.jonas@auckland.ac.nz

Competing Interests

Dr Merry reports affiliation withSafer Sleep LLC outside the submitted work; and is the Chair of Board of Health Quality and Safety Commission in New Zealand.

References

  1. The Health and Disability Commission Code of Health and Disability Services Consumers’ Rights Regulation 1996.
  2. The Health Information Privacy Code 1994.
  3. Waikato District Health Board Image Policy Committee. Information for patients available at http://www.waikatodhb.health.nz/enquiries/guide-for-the-media/medical-photography/ 
  4. Nelson and Marlborough District Health Board. Minutes of Public Meeting. 25 August 2015. Reported in http://www.stuff.co.nz/nelson-mail/news/74398698/Privacy-concerns-prompt-health-board-to-develop-policy-on-cameras-in-hospitals
  5. Australian Medical Association, Medical Indemnity Industry Association of Australia. Clinical Images and The Use of Personal Mobile Devies: A Guide for Medical Students and Doctors. Available at http://ama.com.au/article/clinical-images-and-use-personal-mobile-devices
  6. Figure 1 website. http://figure1.com/
  7. Magin P, Morgan S, Wearne S, et al. GP trainees’ in-consultation information-seeking: associations with human, paper and electronic sources. Family Practice 2015 32:525–32.
  8. Health Insurance Portability and Accountability Act 1996.
  9. Figure 1 website. http://figure1.com/sections/identifiers/
  10. United States Department of Health and Human Services and Office for Civil Rights. Summary of the HIPPA Privacy Rule. Last revised 05/03. Available at http://www.hhs.gov/sites/default/files/privacysummary.pdf: p. 3
  11. Code of Federal Regulations. 45 CFR 164.514 - Other requirements relating to uses and disclosures of protected health information.
  12. Health and Disability Commission. Shared Electronic Health Records: The Management of Withheld Information in Today’s Health Care Environment (A Discussion Document). Submission. 6 March 2015. Available at http://www.hdc.org.nz/publications/other-publications-from-hdc/submissions/shared-electronic-health-records-the-management-of-withheld-information-in-today’s-health-care-environment. Accessed 21 May 2016
  13. Tobin R. Healthcare and Privacy Law. In Penk S and Tobin R, editor. Privacy Law in New Zealand. Wellington; Brookers Ltd; 2010, p161–177.
  14. The Privacy Act 1994.
  15. Case Note 64131 [2006] NZPrivCmr7.
  16. Figure 1. Frequently Asked Questions. How Do I Handle Patient Consent?’ http://figure1.com/sections/faq/index.html Accessed May 20 2016.
  17. Figure 1. Terms of Service. 13 Patient Data and Legal Compliance. http://figure1.com/sections/tos/. Accessed May 20 2016.
  18. Bagg W, Adams J, Anderson L, et al. Medical Students and informed consent: A consensus statement prepared by the Faculty of Medical and Health Sciences of the University of Auckland and the University of Otago Medical School, Chief Medical Officers of District Health Boards, New Zealand Medical Students’ Association and the Medical Council of New Zealand. New Zealand Medical Journal 2015 128:27–35.
  19. Figure 1. Terms of Service. 8 Ownership. http://figure1.com/sections/tos/. Accessed May 20 2016.
  20. Ponemon Institute. Sixth Annual Benchmark Study on Privacy and Security of Healthcare Data. Ponemon Institute May 2016. 

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