Frequently Asked Question: FAQ:

How do I securely store clinical photos in Box?

Other FAQs


Use Box as a "Data Warehouse". You can use Box to keep an archive of clinical photos without violating privacy regulations. This is particularly useful for areas of medicine where it is appropriate to document visual changes over time, and there are no provisions for storing photos in the patients record. Box, in conjunction with PicSafe, can be used to help you comply with HIPAA and HITECH regulations. See the Box HIPAA And HITECH Overview And FAQs for more information. While HIPAA is a US-based standard for protecting patient privacy, it is viewed by many around the world as the gold standard in patient privacy regulation.


  1. Tap on the Settings button (on the primary form).
  2. Tap the Box row under the Storage Integrations heading.
  3. Tap on the Link Box Account button, and you'll be guided through the process to login to Box.


  1. Take a photo in PicSafe.
  2. (Optional) Enter or scan the Patient ID.
  3. Select Box in the send screen.


  • A Box account. If you are doing a trial without using real patient data you can use any Box plan (including free). If you are using real patient data, you will need to set up a Box Enterprise account (required for Box's HIPAA-compliant secure storage) and use "Box Zones". (There is a Box Zone in Melbourne.) The Box website asks that you contact them to get a quote. Expect to pay around US$35 per month for this service, but prices vary depending on how much storage you need. As a rule of thumb, allow 5MB per photo you want to store. You should be able to start off with the smallest plan.
  • PicSafe PRO (or be part of a PicSafe Enterprise account).


  • "Reports" you upload to Box can be found in an automatically generated "PicSafe" directory.
  • A report contains photos (with metadata removed), and a PDF and XML file with the relevant details.
  • Within the Box account, one can use the search to find any of the information included in the "report" (e.g. patients name).
  • The app uploads all reports over HTTPS. We do not encrypt reports using the key server when submitting to Box as we assume that Box stores all reports securely.
  • See the "How do we securely store clinical photos?" FAQ for a discussion on security and data sovereignty issues related to Box.
  • While we believe PicSafe provides a system to allow doctors and comply with various privacy and medical record requirements, you should consult your lawyer or legal department. Note, too often we have seen excessive demands placed on processes to the point that they become impractical. Impractical requirements tend to get ignored, and doctors revert to more comfortable but insecure practices (using the default camera app or the camera within consumer-grade messaging apps). For everyone's sake, we need to avoid this!

What You Get

  • Peace-of-mind. You are putting a system in place that encourages doctors to deliver to the standard of care, thereby mitigating the risk of legal action in a situation where a photo might have changed an adverse outcome.
  • Privacy Regulation Compliance. You're providing a way for staff to securely capture and transmit clinical photos while complying with privacy regulations and thereby mitigating your risk of massive fines.
  • Medical Record Regulation Compliance. By providing the ability to store clinical photos taken on your smartphone, you can comply with medical record regulations. Without this, many images are taken, but they don't make their way into the medical record.
  • Accelerated access to specialist care. Without the worry of breaching privacy regulations, doctors will be more inclined to take clinical photos.
  • Enhanced education for trainees. As above, doctors will be more inclined to take clinical photos and share them with those training.
  • More efficient triaging of patients. Here massive savings can be achieved. Please see the use case for just some examples.