The burgeoning rise of the camera enabled smartphone has imbibed a compelling need to have reality confirmed and experienced in everyone. No visit or experience is complete without having experienced it through a camera lens most of which are on mobile phones. Following this, the picture travels across the globe in a matter of seconds and more people are engulfed in the experience. The phrase “I was there” is almost incomplete without the customary selfie, whatever the occasion.
The need for visual presentism has not left medical practice untouched. Initially used by medical practitioners to document pathology; with the advent of internet connectivity, images have been transmitted over the last decade for medical opinion. Particularly commonly used has been in the monitoring of wounds. This has now been extended to dermatology, rheumatology, ophthalmology, burns management, occupational and physiotherapy and in surgical specialties. These are however, extremely sensitive medical records that, while they have great potential for medical use, also have the potential to compromise patients’ privacy and confidentiality. There is was always the question of legal and ethical implications.
The democratisation of digital photography with the ubiquitous use of camera enabled smartphones and better internet connectivity has enabled people with medical conditions to record and monitor their own problems and send to healthcare professionals to interpret and take decisive action. Sometimes, there maybe transitory events like a resolving facial paralysis or a rash which maybe recorded by the patient and transmitted or even brought to a consultation which may illustrate the events well. While some are extremely articulate in describing their problems, for others a photograph maybe a way of describing problems. Further, these have been extended to actual screening of eyes and transmission of these images to a central hub for interpretation.
Patient generated photography empowers the patient to produce very relevant information that makes medical consultation more effective. Secondly, it also reduces unnecessary clinic or hospital visits when monitoring various pathology. Patient taken photographs reduce recall bias, selective symptom reporting and improves communication between the doctor and patient. Monitoring of various conditions using mobile photography may instill good health related behaviour habits like being more aware of the condition and adopting specific measures. Camera phones are constantly available and this enables health related information to be collected all day. They are an alternative to journal related behaviours such as recording of food intake and document contextual circumstances in self-management of conditions like diabetes.
“Medical selfies” have ethical and legal implications. Currently there is no standardised system of taking photographs and it is up to the competence of the client and provider`s competence to document, transmit and interpret photographs. There is always a possibility of an error in judgement. This lack of standardisation, legal and data compatibility issues are also the limiting factor in incorporating these into electronic patient records. Client consent is another issue which needs to be sorted especially what is related to patient confidentiality. Ultimately each jurisdiction must navigate the complex networks of legislation, institutional policy and codes of practice to develop a solution that suits the needs of their patients.
However, with the passage of time, self-reporting of medical photographs is slowly emerging as an extremely powerful tool in patient engagement, education and empowerment. This has a direct bearing on healthcare access , which is so important to provide better quality and cost effective healthcare.