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The major stages in a photographic workflow sequence involve image capture, storage, editing and output. For clinical photography, security of data and integration with clinical records are additional matters to be considered in the management of images. Image formatFor most uses the JPEG format is adequate although it does compress the file significantly. If one uses the largest size and highest quality JPEG, this has the advantage of retaining resolution with a relatively small file size. If images are to be used for presentations (e.g. Keynote in Mac; PowerPoint in Windows) or in print form, the RAW format is ideal as a starting point, as with these very large data files there is no loss of detail. The image format set-up in the camera allows for both RAW and JPEG images to be taken with a single exposure. The JPEG can be utilized for general purposes (e.g. monitor viewing and email) and the RAW image retained for further post-processing (then saved in a TIFF or JPEG format). The best way to retain image data is to start with a large file and reduce size and format according to the ultimate requirement. Reviewing the imageOne major difference between film and digital photography is the ability in the latter to immediately check the results on the rear LCD screen. Not only can one review the image itself, one can cycle through relevant photo information related to the current image. The most important of these is the histogram that gives a quick graphical display of the light and dark elements captured by the sensor. Many photographers use this to check the quality of the photo exposure in preference to the image itself.Often in reviewing the image on the screen, one will notice overexposure or underexposure of part of the image as well as intrusions and inclusions that were not intended. With sufficient practice and competency, taking a second image will almost invariably resolve these issues and this should take only a few extra seconds. Image transferOnce acquired on a compact flash or SD memory card, images can be uploaded into a computer system via a card reader (e.g. Lexar Professional USB 3.0 Dual-Slot Reader) or via cable.Ideally, images relating to a particular patient should be immediately imported into their digital clinical record. In this way, any question of image modification is offset by the temporal juxtapo- Backup and archivingA routine needs to be imposed for ongoing backup and archiving of photographic data. Traditional concerns with digital storage have been resolved with unlimited capacity now available at very reasonable cost per gigabyte. Patient images on the computer should be backed up regularly and a copy stored offsite.

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