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Access to clinical images

Case Study Four

A patient presented to hospital late at night with injuries she reported were caused by her partner in a domestic violence incident. The doctor used his smartphone to take photos of the injuries. The patient later subpoenaed her medical record from the hospital. Neither the photos nor audio recording were produced to the court. The court required production of the photos and audio recording on the basis that they formed part of the patient’s records. The doctor had kept the images on his phone. 

Keep in mind that patients are entitled to request access to, and obtain a copy of, their health record, including any clinical images. These images may also need to be produced to a court for legal proceedings.

Receipt of clinical images

Case Study Five

A Registrar is at home on call. At about 11.30pm, he is woken by an intern who wants to send him a clinical image on his smartphone to obtain advice about a patient. The Registrar reviews the image and calls the intern to provide the necessary advice. He then goes back to sleep, leaving the clinical image on his phone.

If you receive a clinical image from a third party on your personal mobile device, you are bound by the same legal and ethical requirements as if you had taken the image. You will need to consider what your obligations are regarding the acquisition, quality, use and disclosure, storage, and disposal of the clinical image. It may be necessary to discuss this with the person who sent you the image. 

In most cases, the person who obtained the image has the responsibility for incorporating the clinical image in the patient’s health record. Once this is done, it is not necessary for the receiver of the image to retain a copy as well, and it should be deleted from the personal mobile device.