title: Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.
abstract: BACKGROUND
  Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients.
  
  
  METHODS
  Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use.
  
  
  RESULTS
  Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management.
  
  
  CONCLUSIONS
  Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession.
authors.affiliation: Sydney Law School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Abbott
authors.affiliation: Sydney Law School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Magnusson
authors.affiliation: NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Gibbs
authors.affiliation: The Dermatology and Skin Cancer Centre, Gosford, New South Wales, Australia.|Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.|Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Saxon D
authors.initials: SD
authors.lastname: Smith
mesh_terms: D001315:Australia; D003219:Confidentiality; D003880:Dermatology / Q000295:instrumentation* / Q000331:legislation & jurisprudence; D004282:Documentation; D006801:Humans; D007258:Informed Consent; D016134:Organizational Policy; D010781:Photography / Q000295:instrumentation* / Q000331:legislation & jurisprudence; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011996:Records; D012017:Referral and Consultation; D000068997:Smartphone / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: clinical photography; consent; law; liability; m-health; medicolegal; mobile health; privacy; smartphone; teledermatology