Smartphone communication between healthcare providers: quality and timeliness meets privacy

The exchange of information between health providers is a critically important piece of modern medicine. Timely, accurate information helps patients and enhances quality. A picture is worth a thousand words, as they say. If I need an opinion from a dermatologist, should I write to her and say, “the lesion is a raised papule with irregular borders”, fax it to her office, and wait 6 months for my patient to get an appointment; OR should I snap a pic with my smartphone, send it to her, and get an answer back in 5 minutes – so that I can inform the patient of the dermatologist’s opinion in real time? (Or even within 24 hours – in which case I can call or email my patient with the opinion…..)

Or how about when I, as a cardiologist, get a call in the middle of the night from a young family doctor in Moose Factory (the only doctor in town) who has a patient having chest pain? The young doc is concerned about some ECG changes, but he isn’t quite sure. He just graduated, and he hasn’t seen too many patients with chest pain. Should he transfer the patient south, by air ambulance, to Kingston? Should he fax me a grainy copy? (I don’t even own a fax machine – does anyone? I’d have to drive into the hospital to see it.) Or should he snap a quick pic of the ECG with his smart phone and text it to me, followed by me calling him back with a, “oh, that’s fine nothing to worry about”, or “better get him down here – that looks like an early heart attack”?

To me, the answer is easy. Smartphone communication is awesome, fast, and dramatically enhances the quality and timeliness of patient care.

The privacy concerns cannot be simply pooh-poohed, however. Your personal patient data are confidential, and must only be shared with those involved in your circle of care. Your funny skin bump or your ECG have no business being in my pictures folder next to pictures from my last family reunion. And how do we make these images part of your medical record when they are only on our personal smart phones?

These are the challenges we face as we try to practice 21st Century medicine with 1980’s technology. I mean honestly – FAXES? Yes – we still rely on faxes to transmit patient documents. We cling to the belief that your patient record is more secure when it is transmitted by fax (clearly this is not true – one missed digit; one paper dropped to the floor for the housekeeping person to pick up…)

We need an adult conversation in this country about medical information. Doctors want to serve their patients and patients want timely, quality, care. Instant, electronic communications are clearly the way forward. Instead of hand-wringing on privacy issues and clinging to fax technology, let’s figure out a way to make electronic medical communications secure. The banks have figured it out. Why can’t we?
Saving lives or risky pics? ‘Revolution’ in MDs’ smartphone photos raises ethical concerns

5 Comments

  1. Excellent post, Dr. Chris Simpson ! Electronic Communications has a life affirming place in modern medicine.Privacy may have to pause here. Do it, secure it and make it a heart beat away.

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  2. Excellent post ,Dr. Chris Simpson ! Electronic Communications have a life affirming place in modern medicine today.Privacy may have to pause here .Do it, secure it and make it a heart beat away.

  3. Excellent write up about an important issue faced by physicians these days.
    Now that ‘what’s app’ communication is reportedly’secure’ could one consider image transfer and quick communication using what’s app??

  4. The convenience and potential cost-saving from using cell technology is indisputable — but so is the risk from transmitting unencrypted medical images and info to/from people who are well educated in medicine but typically less so in matters relating to technology and privacy. From the patient’s perspective, trusting a doctor is one thing, but trusting that the doctor is well versed in keeping sensitive information secure and private is another matter entirely. And hoping that the systems and networks over which the data will travel have been designed to be secure, encrypted and private — and that they won’t be breached — is wishful thinking.
    So… start by exploring all of the settings in the devices and apps you use (which are often unsecure by default), and change the settings to safeguard privacy. Turn the location settings off, especially for photos. (Does anybody really need to know the precise geolocation of the patient?) Put a strong password on your cellphone to minimize unauthorized access. Verify recipients’ contact information before sending anything sensitive, and encrypt whatever you send. And get some good training for yourself and your staff on how to safeguard privacy — which will make it much more likely that you’ll be able to comply with privacy laws, and avoid embarrassing data breaches as well as the the harsh glare of media attention and scrutiny by patients, regulators, and Privacy Commissioners.

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