Sometimes surgeons used videos of operations for teaching; sometimes physicians take pictures of rashes for diagnostic purposes. These would fit under the proposed rule, even if not of direct benefit to the patient. I think the Board should include a sample consent form with ithis regulation
By Kim Masters on Jun 06, 2017 at 3:07pm
I agree with the above. There should also be a provision where the provider has the right to refuse the examination if the examinee wishes to record either by audio or photography (still or video) of the encounter.
This issue arises when the examination is being performed as part of an Independent Medical Examination which which often has adversarial overtones and potentially litigious clients.
At least there should be prior notification of the desire of the examinee’ s plan to do same ahead of time and the practitioner provided with a copy.
There is too much chance of poor lighting, editing, camera angles, distance, and overall quality affecting the outcome.
When the state of New York permittted clients to record the examination without even notification of the practitioner - essentially in secret- I terminated my relationship with the state of New York to perform such examinations.In the proposed N.C. Regulation, I think it would be a good idea to incorporate a clause that - IF the patient/examinee - desires, they be provided with a copy of the images.
Basically a good idea with refinements,
Robert Blake, MD, CIME
Gastonia, NBy Robert Blake, MD on Jun 06, 2017 at 4:28pm
How does this position apply to a “mugshot” photo that is taken for attachment to the electronic medical record? Specifically, should written informed consent be obtained for this purpose, or is a head-and-shoulders portrait photo simply considered an element of identifying personal information similar to the usual demographics that are collected? I think that the latter is more reasonable.
By Craig Steffee, MD on Jun 07, 2017 at 8:04am
We have encountered circumstances when staff used personal, mobile devices for photography in the clinical setting. This has raised concerns from auditors that there are no or inadequate audit trails of how or where an image is subsequently used. It may be prudent to stipulate that imaging in a clinical setting may only be done using devices owned by the practice with SOP that prevent personal use of such devices.
By Dante Landucci MD on Jun 22, 2017 at 12:10pm
As for the earlier comment about taking my photograph as part of my medical record, I perceive doing so without the option to decline as unacceptably intrusive. When there may be any question, clinical procedures already permit confirmation of identity by asking relevant questions and/or by requesting select documents that may include photo ID. Clinical staff are not responsible for confirmation of identity. This is a law enforcement activity that, when undertaken by healthcare personne, risks intrusion into the fiduciary healthcare relationship and/or may not be conducted correctly. Furthermore, clinical staff have an obligation to refer matters for law enforcement consideration when there is suspicion of felonious criminal activity.
