Smartphone use in dermatology for clinical photography and consultation: A study of current practice and the law

Abstract

Smartphones are changing the way doctors communicate with each other, by enabling instant capture and transmission of high-quality clinical images for specialist review. This increase in transmission of clinical images is occurring in the absence of reflection about whether smartphone review is the most appropriate way of assessing the patient in the circumstances, and the risk that smartphone review may potentially compromise clinical care and security of patient information. There is also a lack of clarity as to when a duty of care may arise on the part of the recipient of clinical images, and what is required to discharge that duty. Although smartphone consultations are increasingly taking place across a number of medical and surgical specialties worldwide, the practice is particularly prevalent in dermatology due to the highly visual nature of the specialty. This thesis investigates current clinical practices regarding smartphone use in dermatology through a survey and qualitative interviews with Australian dermatologists and dermatology trainees, and examines the medicolegal implications, with a particular focus on questions of liability in negligence. It also considers questions of patient privacy and consent to undergo clinical photography and to be reviewed via telemedicine. The thesis then proposes practical solutions to address the limitations of smartphone clinical use, with a focus on software integration, education and a pragmatic approach to policy.