Stakeholders’ Perceptions Regarding the Use of Patient Photographs Integrated with Medical Imaging Studies

Abstract

Integrating digital facial photographs of pediatric patients as identifiers (ID) with medical imaging (integrated photographic IDs) may increase the detection of mislabeled studies. The purpose of this study was to determine how different stakeholders would receive this novel technology. Parents or guardians of patients in a children's hospital outpatient radiology department, radiology faculty and residents, and radiology technologists and nurses were asked to complete a survey. The perception about the anticipated use of integrated photographic ID in different clinical scenarios was investigated, and its predictors were determined using logistic regression analysis. Four hundred ninety-eight parents responded (response rate 83 %); 96 and 97 % supported the use of integrated photographic ID, if it improves the radiologist's imaging interpretation or decreases the rate of mislabeled errors, respectively. Thirty-eight percent were worried that photographic IDs would impact patients' privacy. Ninety-four percent believed that they should be asked for their consent prior to obtaining their child's photograph. Seventy-eight radiologists responded (response rate 39 %); 63 and 59 % believed that the use of integrated photographic ID would result in improvement in accurate interpretation of images and identification of mislabeled patient errors, respectively. Forty-nine percent of radiologists had concern that integrated photographic ID would increase interpretation time. Fifty technologists and nurses responded (response rate 59 %); 71 and 73 % supported the technology if it resulted in more acute interpretation of images and identification of mislabeled patients, respectively. A majority of stakeholders support integrated photographic ID in order to improve safety. A majority of parents believe that consent should be obtained.

Observation and Patients’ Perceptions of Incorporating Their Photograph Into the Electronic Health Record

“…These findings are consistent with prior research of patients' acceptance of photographs for patient identification in pediatrics 7 and acceptance of clinical photographs in teledermatology, radiology, general internal medicine, anesthesiology, and for use in medical education, which demonstrates that patients are generally willing to share their PHI with clinicians, even when they have concerns about privacy and information security. [12][13][14][15][16][17][22][23][24][25][26][27] For example, one study demonstrated that, although 82% of patients had concerns about the security of EHRs, 75% agreed that the benefits of EHRs outweighed the risks to security. 25 Another study revealed that patients were open and willing to share PHI with clinicians, and their comfort with sharing information increased when privacy concerns were addressed by clinicians.…”

“…Among patients enrolled in a pilot study in an ED, 84% had positive attitudes toward the use of clinical photographs for medical education 17 . A survey of parents at a pediatric hospital found that 96% of parents would support the integration of their child’s facial photograph with imaging studies as a strategy to reduce identification errors 16 . However, no study to date has assessed the perceptions of adult patients having their photograph taken upon registration and incorporated into the EHR to improve patient identification.…”

“…An additional potential barrier is patient refusal. Several studies have shown low rates of patient refusal for clinical photographs (e.g., photographs of skin rashes) used for patient care and medical education 12–17 . Lau et al 13 found that 98% of patients would accept having a clinical photograph in the medical record if it were used by their health care provider for medical purposes.…”

“…Several studies have shown low rates of patient refusal for clinical photographs (e.g., photographs of skin rashes) used for patient care and medical education. [12][13][14][15][16][17] Lau et al 13 found that 98% of patients would accept having a clinical photograph in the medical record if it were used by their health care provider for medical purposes. Among patients enrolled in a pilot study in an ED, 84% had positive attitudes toward the use of clinical photographs for medical education.…”

“…17 A survey of parents at a pediatric hospital found that 96% of parents would support the integration of their child's facial photograph with imaging studies as a strategy to reduce identification errors. 16 However, no study to date has assessed the perceptions of adult patients having their photograph taken upon registration and incorporated into the EHR to improve patient identification. Therefore, we conducted a study to quantify the frequency of patients' refusal to have their photograph captured during registration and to elicit feedback from patients on the perceived benefits and barriers to having their photograph integrated into the EHR.…”