Sending MD pictures of wounds on cell phone?

Specialties Wound

Published

I was seriously asked by one of the attendings to text pictures of wounds during rounds to his cell phone. Needless to say I said "No, but you're more than welcome to come on fridays when we do rounds with the specialist if you'd like to see for yourself how they're healing." My facility does not photograph wounds during weekly measurements/assessments with the wound specialist and there isn't a chance in you know where that I'm going to take a picture of a wound with my personal cell phone to send to the MD or anyone else. I told my DON/Admin about this and they will be taking care of the situation. When I confronted the MD about the request with the statement "why did you ask me to do something you knew illegal?" He stated a lot of the MD's at the "big hospital" do it. I'd be ****** if someone took a picture of a wound on my rear and sent it around to anyone/everyone. Has anyone else heard of doing this? Texting pictures.

Specializes in ER, progressive care.

Text messaging is not secure...and therefore that is a potential HIPAA violation.

Where i work, we have a digital camera that the supervisor keeps...If we need to document wounds, we take pictures and then give the camera back to the supervisor who prints out the pictures to be placed in the patient's chart. That way all providers can see what the wound looks like. We have never used cell phones to take pictures of wounds.

unless you have a VERY strange wound, which would be identifiable unto itself, I don't get the problem. As long as the shot was a close up with no identifiable objects. We have a doc that wants to be text for initial contact on occassion, but he will CALL back.

Another home care nurse here, and yes we do it. We usually take them with our phones and email them to the Doctor. Our patient knows and watches me delete the photos after I send them. The doctor comes only once a month and I do wound care everyday. They need to be updated frequently and they want a photo. The patient's name or any identifying features are not included. It could literally be anyone in the world as far as someone seeing it could be concerned. I have to look out for my patient. For the Doctor, he thinks the best way to closely monitor it is via photo and I agree.

I do not agree with taking pictures of wounds with your personal cell phone. this is an example from what happened to a co-worker. she took a picture with her personal cell phone with the pt permission and with the pt watching her delete the picture. the pt later sued the physician over complications with the wound. the pt of course reported that a picture was taken by the nurse and sent to the physician. Her personal cell phone was brought in as evidence. even though the picture was deleted they were able to retrieve the picture. all her personal information and whatever was on that phone was brought in as evidence. If you are asked "do you use your cell phone at work" and you respond yes, your phone can be used as evidence and you can be brought in as a witness. I do not know all the details of the situation, but I do not take pictures of wounds with my phone. If you are using a company or facility phone and the policy allows this then OK.

I'm a Director of nursing at a SNF and the wound care director. This is an absolute breech of confidentially. Even texting an MD for orders is a HIPPA violation. If I found out that anyone of my staff nurses did this, they would be terminated on the spot. Imagine if that was your family member!! Come on people... Be an advocate for your patients

While I absolutely understand where you are coming from in regards to a HIPPA violation, I do not agree with your conclusion that these providers are not advocating for their patients. The circumstances in which I have seen this done, and from the accounts presented by people in this tread, I absolutely feel that they were advocating for their patient. A photo sent on a cell phone often means coordinated care. It may mean that a patient gets treatment faster, or may even mean they get the proper treatment. It's lovely to say the doc has to come by and see the patient her/himself, but the reality is that it may not happen in a timely manner, or never at all, depending on the setting and the provider. Legally they are putting themselves at risk, but I believe in most cases they are in fact advocating for their patient in the best way they can with the resources they have.

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