Patient Perceptions of Dermatologic Photography: Scoping Review

Abstract

Background Medical photography is used extensively in dermatology to record disease progression, measure treatment response, and help teach patients about skin disease; such photos are also commonly utilized in teledermatology, medical education, research, and medical reference websites. Understanding patient perceptions of medical photographs obtained during dermatologic care in the clinic or hospital setting is critical to enable the delivery of high-quality, patient-centered medical care. Objective The aims of this study were to elucidate patient perceptions of skin photos in dermatology and to explore possible next steps in improving the patient experience with medical photography in the hospital or clinic setting. Methods A scoping review of the literature was performed using the PubMed database, with clinic- or hospital-based full-text publications in English spanning the last 10 years considered for inclusion. Results The majority of included studies (10/11, 91%) found positive patient attitudes toward medical photographs. The majority of patients (1197/1511, 79.2%) felt that medical photographs could improve medical care in the clinic setting. Written consent detailing all photo uses, including secondary uses (such as research or teaching), was preferred, apart from in 1 study. Patients preferred or found it acceptable for the photographer of their medical photos to be a physician (1301/1444, 90.1%). Clinic-owned cameras with departmental record storage were the preferred modality. Latinx and African American patients expressed less trust in the utility of medical photographs to improve care, compared with Asian and White patients. The minimal number of available publications on this topic and the inclusion of articles older than 5 years are limitations, since patient perceptions of medical photography may have rapidly changed during this time span, particularly in light of the COVID-19 pandemic and the subsequent increase in teledermatology visits. Conclusions Patients reported positive perceptions of dermatologic photography for improving their medical care. Ethnic disparities in patient perceptions require further exploration to better elucidate nuances and develop interventions to improve the experience of marginalized patients. Building patient trust in nonphysician photographers may enhance clinic efficiency. Although clinic-owned cameras are well-accepted by patients, improved patient education surrounding the safety of electronic medical record phone applications is needed.

A Glance at the Practice of Pediatric Teledermatology Pre- and Post–COVID-19: Narrative Review

“…With store-and-forward platforms, good photography forms the basis of the consult—where clinical photos inform on the evolution of a skin disease and assist in more objective assessments of a patient when different doctors are involved in patient care such as in larger public hospitals [ 5 ]. A scoping review by Kim and Sivesind [ 7 ] had also demonstrated that patients adopt positive attitudes toward medical photography. Most patients had expressed that medical care could be improved in the clinical setting with photography [ 7 ].…”

“…A scoping review by Kim and Sivesind [ 7 ] had also demonstrated that patients adopt positive attitudes toward medical photography. Most patients had expressed that medical care could be improved in the clinical setting with photography [ 7 ].…”

“…There are also disparities in trust toward dermatologists providing teledermatology among patients of different racial groups. Kim and Sivesind [ 7 ], in a scoping review, revealed that patients of Latin and African American descent had expressed less trust in the utility of medical photography to improve patient care, compared to patients who were Asian and White. Ethnic disparities in patient perceptions may need to be taken into consideration by practitioners to improve the teledermatology experience for socially marginalized patients.…”

“…Ethnic disparities in patient perceptions may need to be taken into consideration by practitioners to improve the teledermatology experience for socially marginalized patients. This could be done by using nonphysician photographers and clinic-owned cameras, and by improving patient education surrounding the safety of electronic medical record phone apps [ 7 ].…”

Store-and-Forward Images in Teledermatology: Narrative Literature Review

“…For this reason, clinicians should obtain proper patient consent, explain how images will be used, and delete the images from their smartphones after being uploaded to patient charts while ensuring sufficient security in their digital communications [ 50 ]. In general, patients prefer giving verbal consent and their photographs being taken by clinic- or hospital-owned cameras [ 51 ]. EHR programs such as Epic and Cerner as well as new mobile apps allow for the secure upload of patient images to their medical charts without permanent storage on the user’s device [ 52 ].…”