Patients' Experiences and Attitudes of Using a Secure Mobile Phone App for Medical Photography: Qualitative Survey Study

Abstract

Background Point-of-care clinical photography using mobile devices is coming of age as a new standard of care for clinical documentation. High-quality cameras in modern smartphones facilitate faithful reproduction of clinical findings in photographs; however, clinical photographs captured on mobile devices are often taken using the native camera app on the device and transmitted using relatively insecure methods (eg, SMS text message and email) that do not preserve images as part of the electronic medical records. Native camera apps lack robust security features and direct integration with electronic health records (EHRs), which may limit patient acceptability and usefulness to clinicians. In March 2015, Mayo Clinic overcame these barriers by launching an internally developed mobile app that allows health care providers to securely capture clinical photographs and upload them to the EHR in a manner that is compliant with patient privacy and confidentiality regulations. Objective The study aimed to understand the perceptions, attitudes, and experiences of patients who were photographed using a mobile point-of-care clinical image capture app. Methods The study included a mail-out survey sent to 292 patients in Rochester, Minnesota, who were photographed using a mobile point-of-care clinical image capture app within a preceding 2-week period. Results The surveys were completed by 71 patients who recalled being photographed. Patients were seen in 18 different departments, with the most common departments being dermatology (19/71, 27%), vascular medicine (17/71, 24%), and family medicine (10/71, 14%). Most patients (49/62, 79%) reported that photographs were taken to simply document the appearance of a clinical finding for future reference. Only 16% (10/62) of patients said the photographs were used to obtain advice from a specialist. Furthermore, 74% (51/69) of the patients said they would recommend medical photography to others and 67% (46/69) of them thought the photos favorably affected their care. Patients were largely indifferent about the device used for photography (mobile device vs professional camera; 40/69, 58%) or the identity of the photographer (provider vs professional photographer; 52/69, 75%). In addition, 90% (64/71) of patients found reuse of photographs for one-on-one learner education to be acceptable. Acceptability for other uses declined as the size of the audience increased, with only 42% (30/71) of patients deeming reuse on social media for medical education as appropriate. Only 3% (2/71) of patients expressed privacy or confidentiality concerns. Furthermore, 52% (33/63) of patients preferred to provide consent verbally, and 21% (13/63) of them did not think a specific consent process was necessary. Conclusions Patient attitudes regarding medical photography using a secure EHR-integrated app were favorable. Patients perceived that photography improved their care despite the most common reason for photography being to simply document the appearance of a clinical finding for future reference. Whenever possible, health care providers should utilize secure EHR-integrated apps for point-of-care medical photography using mobile devices.

Assessment of the Fairness of Privacy Policies of Mobile Health Apps: Scale Development and Evaluation in Cancer Apps

“…Mobile health (mHealth) apps are one of the technological breakthroughs that make this possible. There are more than 3 billion smartphone users worldwide, and this number is predicted to grow by several 100 million in the next few years [ 2 ]. This proliferation of smartphones has led to an increase in the availability and abundance of mHealth apps.…”

Patient Perceptions of Dermatologic Photography: Scoping Review

“…Table S1 in Multimedia Appendix 1 provides further granularity, categorizing perceptions by category: consent, photographer role and badge, gender, photograph capture method, image storage, image use and identifiers, mental well-being and trust, and ethnic variations. [11] Patients' experiences and attitudes of using a secure mobile phone app for medical photography: qualitative survey study Positive perceptions, with majority (67.5%) satisfied with medical photography of skin lesions N=200 Hospital South Iran 2021 Amirian et al [12] Study of patients' satisfaction toward photographing their skin lesions for educational purposes Positive perceptions of scalp photography as being helpful (98.3%) and increasing motivation (98.3%) to complete alopecia treatment N=119 Outpatient setting Boston, MA 2021 Pathoulas et al [3] Evaluation of standardized scalp photography on patient perception of hair loss severity, anxiety, and treatment a EHR: electronic health record.…”

“…Overall, the majority of included studies (10/11, 91%) found positive patient attitudes toward medical photographs [1,[3][4][5][7][8][9][10][11][12]. Additionally, many dermatology patients (1197/1511, 79.2%) felt that medical photographs could improve their care, diagnosis, or treatment in the clinical setting [3][4][5][6]8,11].…”

Assessment of the Fairness of Privacy Policies of Mobile Health Apps: Scale Development and Evaluation in Cancer Apps (Preprint)

“…The first was the data controller's country. We identified 4 groups: EU apps (8), US apps (9), apps (3), and apps from unknown countries (2). According to our analysis, the fairness of EU privacy policies was much better than those from the United States, with 75% (6/8) of EU apps above 50 points, and 4 of them in the first category.…”