What radiologists should know about point-of-care photographs

Point-of-care photographs obtained at the same time as medical imaging studies can be helpful for radiology providers. According to a new perspective piece published in the American Journal of Roentgenology, however, specialists should still make sure they do their homework before using such photographs in their practice.   

“The chief advantage of incorporating patient photographs, particularly facial photographs, is that faces can serve as intrinsic, externally obtained biometric identifiers,” wrote Srini Tridandapani, MD, PhD, of the department of radiology and imaging sciences at Emory University in Atlanta, Georgia, and colleagues. “In prior observer studies, we showed that facial photographs can significantly increase the rate of detection of simulated wrong-patient errors during radiograph interpretation. This detection is aided by a comparison of current and prior photographs obtained along with the radiographs.”

Radiologists who may be using point-of-care photographs, the authors noted, should make sure they learn the basics when it comes to the legality of such images.

According to the Health Insurance Portability and Accountability Act of 1996 (HIPAA), photographs featuring the patient’s face are considered protected health information just like the patient’s name or date of birth. This means photographs including the patient’s face are viewed as “identified” and radiologists would not be doing any harm as long as they are “handled appropriately.” Tridandapani et al. also noted a majority of patients are in support of point-of-care photographs being usedif they are proven to offer added safety and improved quality for patients.”

This is all good news for radiologists, but they still must be careful.

“A potential legal pitfall is whether radiologists may be held liable for findings on the photographs,” the authors wrote. “For example, if a skin lesion is visible on a point-of-care photograph and later becomes cancerous, would it be considered negligence if a radiologist does not report it? An argument against this potential pitfall would be that if such a lesion was visible on a 2D photograph from several feet away, that lesion should have been visible and noted by the various primary care physicians taking care of the patient in closer quarters.”

Tridandapani and colleagues did argue in their study, however, that photographs should still be used if they can be helpful.

“Such documentation may, in fact, be legally protective for health care providers who perform their duties appropriately, similar to the protection that body cameras are likely to provide for police officers who conduct themselves professionally and appropriately,” they wrote.