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Taking a photo

Keep clinical pics safe, help doctors comply with privacy regulations, and reduce healthcare costs.

89% of doctors, while trying to deliver better and more efficient care, use their phone for clinical photography. They're inadvertently breaking the law, risking huge fines, and they're vulnerable to cyber-extortion. Support doctors and hospitals by giving them PicSafe®. Increase privacy regulation compliance while helping save lives and reduce healthcare costs.

The PicSafe® Solution

  • Just as easy as using the default camera app the default camera
  • Encrypts your photos before sending
  • Wipes patient data once sent
  • Documents patient consent
DOWNLOAD FREE
PicSafe on an iPhone X

Six ways doctors often break the law when taking clinical photos

Using the default camera app, or the camera built in to messaging apps, almost always results in a breach of privacy regulations.

1

Express consent isn't documented

2

Photos are stored on your phone

3

Photos are auto-uploaded to iCloud

4

Photos aren't de-identified properly

5

Lose your phone, lose patient data

6

Sent insecurely via email or SMS

1. Express Consent Isn't Documented Properly

Doctors often don't get consent, and when they do, they don't record it properly. A whopping 82% of the time, doctors don't document consent when taking a photo. A study among dermatologists revealed that only 2% obtained written consent! While 46% received verbal consent, they failed to document this.

See the "Can't I just infer consent? FAQ for details.

2. Clinical Photos Are Stored Alongside Personal Photos

In a 2016 study, 73% of doctors admitted to storing clinical photos among their private photos, while 26% admitted to accidentally having shown a clinical photograph on their phone to friends or family! That's an instant privacy breach.

Even if a doctor "deletes" a photo, on iOS devices it remains in "deleted items" folder for 40 days, and on Android devices it remains in the "trash" folder for 60 days. See the "How do I delete clinical photos I have stored on my photos FAQ.

3. Patient Data Leaves the Country

There are two ways in which you can inadvertently be sending data cross borders:

  1. All iOS and Android devices steer you into automatically backing up your photos to their servers by default.
  2. If sending a text message from an iPhone to a recipient with an iPhone, it is, by default, sent via iMessage, not SMS. If sent via iMessage, although encrypted, data again leaves the country. See the FAQ Is sending patient data via iMessage safe? for more.

You should never have patient data on Apple or Google's servers.

  • There have been security breaches in the past (e.g. the celebrity "hacking" scandal).
  • Privacy regulations forbid sending patient data internationally.
  • The US Patriot Act (2001) potentially enables foreign entities to rifle through patient data, without your knowledge.

4. De-identifying Photos Isn't/Can't Be Done Properly

Many operate under the assumption that they can merely de-identify the photos by not showing the patients face; however, this is not sufficient. Photos taken on the default camera app (or the camera within messaging apps) contain all sorts of metadata that can be used to identify the patient. See "Am I okay to use the default camera app if I de-identify photos?" in the FAQs for more.

5. Clinical Photos Are Accessible If You Lose Your Phone

Fortunately, all new iOS and Android phones have some form of a passcode, or facial recognition turned on by default. Unfortunately, between 11% and 15% of iOS devices, and around 33% of Android devices don't have it turned on.

While newer versions of iOS and Android push people into using passcodes, fingerprint scanners or face recognition, sometimes (on some Android devices) these methods are quite easy to "hack". Whether such measures are considered "reasonable" has not been legally tested.

With off-the-shelf data recovery tools, one can recover data on "locked" Android devices reasonably easily.

6. Sending Patient Data Unencrypted Isn't Safe

Sending clinical photos by email, text message, and even WhatsApp is widespread, but it should not be happening!

Email

Email is inherently insecure. Unless you're using a special email encryption service, it's like sending a postcard. Any number of people can view it along the way.

See the Is Sending patient data via email safe? FAQ for more.

Text Message

Simply put, text messaging is not secure.

  • There's a vulnerability in mobile network infrastructure that makes intercepting text messages trivial;
  • Messages are stored indefinably on the sender and recipient's device; and
  • iOS sends messages to other iOS devices via iMessage (see above).

See the Is Sending patient data via text message (SMS) safe? FAQ for more.

WhatsApp

In the UK the use of WhatsApp is now ubiquitous in NHS hospitals. Anecdotally, many doctors are using WhatsApp to share patient data.

  • US owned WhatsApp uses end-to-end encryption. Good but not the holy grail of security. Cough, "Snowden".
  • A 2017 a security vulnerability exposed the data of millions of users. It was quickly patched but it's still concerning.
  • By default, received and captured photos appear in the phones gallery.

See the Is Sending patient data via WhatsApp safe? FAQ for more.

£500,000 fines for a privacy breach!

Sending patient data unencrypted is like sending a postcard. Content, as it travels across the Internet, can be easily intercepted leaving you exposed to significant fines for each privacy breach. Individual trusts could face penalties of up to £500,000 if breaches lead to substantial damage or distress to patients. £3,000,000 in privacy fines were issued in 2016.

Protect Doctors From Cyber-extortion

Cyber-extortion is increasing at a rate of 350% per year with "rich" western healthcare systems being prime targets.

As seen on 60 Minutes (America) , there's an unfixable vulnerability in mobile networks meaning it's easy for hackers to intercept text messages from anywhere in the world. All they need is a phone number.

89% of physicians polled admitted to taking clinical photos on their phones, and the practice of then sending them via text message is rife. A hacker can easily intercept messages and threaten to reveal patient data unless they receive an anonymous Bitcoin payment.

  1. The doctor/clinic/hospital is ethically obligated to notify the patient.
  2. The doctor/clinic/hospital is ethically bound to notify the Information Commissioners Office (ICO) of the privacy breach.
  3. Under the Data Protection Act, the doctor/clinic/hospital may be issued a fine up to £500,000 by ICO for using insecure practices.
  4. The responsible doctor may face suspension, dismissal or other disciplinary action for using insecure practices.

FBI Logo FBI The FBI has issued a warning that hackers are actively trying to access patient data to "intimidate, harass and blackmail". By encrypting photos on your device before sending them, PicSafe® helps protect you from this threat.

As seen in...

Royal Australasian College Of Surgeons

Medical Record Integration

Easily add clinical photos into third-party Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems.

IT-less Integration

Send a report to yourself, decrypt and open it at my.picsafe.com, and import it into any third party tool that can accept JPEGs and PDF's. No complex setup required - no need for help from IT!

PicSafe is Literally on FHIR

Send reports directly to Fast Healthcare Interoperability Resources (FHIR) supported EMR/EHR's. FHIR is the emerging standard for exchanging health information to and from electronic health records.

For more, see "How do I get photos into the medical record?" in the FAQs.

Standard of Care

Use of the camera on phones for clinical photography is so widespread, and the benefits so broadly accepted that it can be considered "standard of care". That means you're...

Damned-if-you-do

Using current standard practices, hospitals and doctors (personally) are likely breaching privacy regulations.

Damned-if-you-don't

Patient care is less efficient, lives can be lost, and there's a risk of litigation for not delivering the standard of care.

We use Advanced Encryption Standard 256-bit keys

PicSafe® also uses CBC mode, password stretching with PBKDF2, password salting, random IV, and encrypt-then-hash HMAC. There are no known cases of this encryption having ever been "cracked".

Security Tested

PicSafe® has undertaken independent Vulnerability Assessment and Penetration Testing (VAPT). See the PicSafe® Security page for more.

How to send a PicSafe® “Report”

Download PicSafe® Now FREE

There is a paid version with advanced features although the free version will suit most people.