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Taking a photo

Your medical pics aren’t safe without PicSafe®

Medical photos aren't stored or transmitted securely when using the default camera app, or the camera within messaging apps. In most cases, you're risking massive fines by inadvertently breaking the law, and you're vulnerable to cyber-extortion. Use PicSafe's compliant medical photography app to protect you and your patients. Download Now - Free

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 you might be breaking the law when taking medical 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. Medical Photos Are Stored Alongside Personal Photos

In a 2016 study, 73% of doctors admitted to storing medical photos among their private photos, while 26% admitted to accidentally having shown a medical 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 medical photos I have stored on my photos FAQ.

3. Patient Data Gets Stored Non-HIPAA Compliant Servers

There are two ways in which you can inadvertently be sending data to Apple/Google servers:

  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 ends up on Apple or Google servers. 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 the use of non-HIPAA compliant services.
  • With the enactment of the US Patriot Act (2001), you get no oversight as to whether various government entities have rifled through patient data.

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. Medical 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 medical 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

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.

Why Risk HIPAA Fines & Penalties?

Sending patient data unencrypted is like sending a postcard. Content, as it travels across the Internet, can be easily intercepted leaving you exposed to HIPAA violations and fines.

* HIPAA's Security Rule (Security Standards for the Protection of Electronic Protected Health Information, found at 45 CFR Part 160 and Part 164, Subparts A and C) requires: ENCRYPTION (A) - 164.312(e)(2)(ii) - You must, "Implement a mechanism to encrypt electronic protected health information whenever deemed appropriate." STANDARD 164.312(e)(1) Transmission Security - You must, "Implement technical security measures to guard against unauthorized access to electronic protected health information that is being transmitted over an electronic communications network.".

HIPAA compliant

Protect Yourself From Cyber-extortion

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

As seen on 60 Minutes , 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 medical 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 is ethically and legally obligated to notify the patient.
  2. The doctor is legally bound to notify the U.S. Department of Health & Human Services (HHS), and in some cases, the media of the privacy breach.
  3. Under HIPAA rules the doctor may be issued a fine 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 medical 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.