The Surgeon and the Smartphone – 'Wanna See My Surgery Pictures?'

August 17, 2011

A smartphone can be a provider's dream in explaining procedures to patients and family, but also a possible legal and ethical nightmare.

My wife had minor surgery recently (carpal tunnel release). While she was in surgery, another surgeon came out to the waiting room to chat with a wife/girlfriend of another patient that had gone in earlier for surgery. He was still in surgery scrubs, including cap and mask (but presumably his operating gloves and gown were disposed of already in the operating corridor.)

I really wasn't paying that much attention, as I was catching up on some e-mails on my laptop. But I could hear enough of the conversation to catch a bit of what was going on. The surgeon said her guy's surgery had gone well. I got the impression it was some kind of "re-do" surgery because earlier when the guy was in the waiting room he already had a bandage similar to the one my wife ended up with after her surgery.

He told the young woman things had worked out fine, he had to clean some things up, move a flap of tissue from here to there, etc. But then he brought out his smartphone and showed her some pictures, apparently taken during the surgery, and was pointing out details of the surgery.

That caught my attention.

The pictures were obviously helpful in communicating the patient’s medical situation and details of the operation, as she nodded as she looked at the pictures and listened to his explanation of the procedure.

The fact that he has pictures on his smartphone means he is taking pictures of his patients during their surgery. I’m hopeful that he had the permission of the patient - in the form of a medical release- not only to take the pictures, but to share them.

But it does bring up some other interesting issues:

• Did the surgeon’s smartphone have appropriate data security?
• Was it his personal phone or did it belong to the practice/surgery center?
• Since HIPAA Security requires a formal policy on data and media destruction, what is going to happen to those pictures? When, where and how are they going to be disposed of?
• Was the phone sterilized (or at least wiped down a bit) before/after surgery?
• Did he take the pictures himself or have a staff member take them? (If he took them himself, how did he do it without contaminating his surgical gloves?)
• Where else has that smartphone been, and where does it go after surgery?
• With numerous other apps on the phone, including many that have recently been shown to access other information and settings on the phone in ways that are unknown to/untraceable by users, who else could possibly access that information?

Clearly the ability to document certain details of the surgery makes it easier to explain things to the patient and/or family members, but is this acceptable procedure? Do you have procedures in your facility to address this kind of technology and behavior by physicians and other clinical/business office staff?

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