Mobile phone use in Clinical Communication
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Mobile phones in Clinical Communication JAKE BARLOW, MBBS @CJDBARLOW JAKEBARLOW.ME/PHONES
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Presentation at smaccGOLD 2014 detailing results of a descriptive survey looking at how critical care doctors use mobile phones and camera photography.
Transcript of Mobile phone use in Clinical Communication
Mobile phones inClinical CommunicationJAKE BARLOW, MBBS
@CJDBARLOW
JAKEBARLOW.ME/PHONES
Background
▪ Clinician photography has demonstrated clinical benefit 1-3
▪ 97% of patients have positive opinions around camera phone photography 4
▪ Observational studies suggest use is growing
▪ No large studies of use conducted
Background
▪ Concerns exist around:▪ Adequacy of consent taken 5
▪ Security of image storage on personal devices 6
▪ Methods clinicians use to share data and images
▪ Lack of policy from governing or regulatory bodies
▪ Survey designed to gauge baseline use of smartphones
Methodology
▪ Multi-centre multi-site survey of 3 major Victorian healthcare networks
▪ Ethics approved by MHREC and each institution
▪ Incentivised online survey over one month
▪ Advertised through posters and email
▪ 46 questions covering different clinical roles and disciplines
Methodology
▪ 212 responses from all disciplines
▪ Subcohort study examining 47 critical care responses
▪ Majority of critical care responses from consultants and HMOs
Key Findings
Key Findings
Key Findings
Limitations
▪ Small cohort limits utility of sub-group analysis
▪ Variation of practice within critical care clinicians
▪ Recall bias
▪ Selection bias to clinicians with smartphones
▪ Dropout
Discussion – Key Issues
▪ Legitimate concerns exist around adequacy of consent taken
▪ Current practice does not appear to be compliant with Australian Health Privacy Principles
Discussion – Key Issues - Consent
▪ Consent is taken inadequately in at least 47% of cases
▪ Discussion in literature focuses predominantly on clinician education to improve quality of consent
▪ Clinical photography guidelines require documented consent
Discussion – Key Issues – Health Privacy Principles
▪ National Privacy Principles enacted on 12 March 2014
▪ Transported Data Flow▪ Health data cannot be stored or routed outside of Australia▪ e.g. iCloud, iMessage, WhatsApp, Dropbox, Google Drive,
Skydrive
▪ Data Governance▪ Security of devices▪ 5% of clinicians surveyed lost phones/USB sticks containing
identifiable patient information▪ Requirements differ depending on intended use
Conclusion
▪ Clinicians are using camera photography as part of their practice
▪ Use does not appear to comply with current legislative standards
References
1. Padmasekara G, Nazarian N, Wall C. The reliability of mobile multimedia messaging (MMS) for decision making in distal radius fractures: an effective alternative. J Mobile Technolog Med 2012; 1: 8-12
2. Lamirel C, Bruce BB, Wright DW, et al. Nonmydriatic digital ocular fundus photography on the iPhone 3G: the FOTO-ED study. Arch Ophthalmol 2012; 130: 939-940.
3. Demaerschalk BM, Vargas JE, Channer DD, et al. Smartphone teleradiology application is successfully incorporated into a telestroke network environment. Stroke 2012; 43: 3098-3101.
4. Tomlinson JK, Myers AJ, Meads BM. “Click first, care second” photography. Med J Aust 20104; 198 (1): 21-22.
5. Burns K, Belton S. “Click first, care second” photography. Med J Aust 2012; 197: 265.
6. Maher PD, Foley PA, Sheed-Finck A, Baker CS. Legal considerations of consent and privacy in the context of clinical photography in Australian medical practice. Med J Aust 2013; 198 (1): 48-49.
