Tehachapi Valley Healthcare District

Tehachapi Valley Healthcare District
POLICY: Patient Photography, Video Taping, and Other Imaging / POLICY NUMBER: 112.01.01.07
Original/Rewrite Approved: 10/31/2002
Originating Dept: Nursing / Reviewed:
Applies to Depts: All Depts.
Med/Surg / Revised: 12/06/2010
Renumbered: 07/19/2011
Emergency
Clinics

Policy:

It is the policy of Tehachapi Valley Healthcare District to utilize a variety of media to collect protected patient health information, and with respect to the patient’s privacy, to hold all identifiable patient medium in a protected and secure manner. Additionally, patient family or friends may be allowed to photograph or videotape patient care activities with the consent of the patient. At any time, patient directed photography or videotaping might be discontinued at the discretion of the attending physician or health care provider as determined in the best interests of patient safety, treatment, and/or healthcare operations.

For the purposes of this policy, “consent” is written documentation of the patient’s agreement to the process, i.e. “Consent to Photograph and Publish” form, NSG 09.The patient has the right to revoke the consent at any time. Photographs, videotapes and/or other images obtained prior to the revocation of the consent and made part of the patient’s health record shall be maintained along guidelines set forth by the organization’s retention policy.

Procedures:

Circumstances Under Which Patient Photography, Videotaping, and Other Imaging is Permitted:

Photography of Decubitus Ulcers: If a patient is admitted to the hospital with decubitus ulcer[1] photographs should be taken on admission only.

Documentation of Abuse and Neglect: Reportable cases of actual or suspected abuse and neglect do not require prior authorization from the patient prior to photography, videotaping, and other imaging. These images may be submitted to the investigating agency with appropriate authorization/court order, but should not be used for other purposes without consent.

Research: Photographs taken as part of a research protocol must be approved by the organization’s institutional review board or privacy board. Consent for photography, videotaping, or other imaging must be incorporated into the patient consent for participation in the research protocol.

Medical Education, Teaching, or Marketing/Publicity: Written consent must be obtained before photographing, videotaping or taking other images of patients for medical education, teaching, or marketing/publicity purposes. The patient/ legal representative should sign and date the consent form. The signed consent form is to be filed with the patient’s health record. A new consent form should be signed for each new series of photographs taken. The consent given for photography remains valid unless and until the patient/legal representative withdraws or restricts the authorization.

Media: When representatives from the news media agencies ask to photograph or videotape a patient, permission may be given if 1) the patient’s provider does not feel it would be detrimental to the patient; and 2) the patient/legal representative signs a written consent form agreeing to the photography.

Law Enforcement: When law enforcement representatives ask to photograph or videotape a patient, permission may be given if 1) the patient’s provider does not feel it would be detrimental to the patient; and 2) the patient/legal representative signs a written consent form agreeing to the photography.

Patients who are or are suspected to be victims of crime may consent to the disclosure of information to law enforcement. However, if emergent circumstances or the patient’s incapacity preclude consent, the provision of PHI to law enforcement must meet a three-prong test:

(1) the necessity of obtaining the information to determine if a law has been violated by a person other than the patient/victim and the requestor’s intent is not to use the information against the patient/victim;

(2) the information is necessary for immediate law enforcement activity and waiting for consent would be materially and adversely affect such activity; and

(3) disclosure of the requested information is “in the best interests of the individual as determined based upon professional judgment.

Photography of Newborns: Consent of the parent must be obtained prior to the taking of photographs of newborns as a courtesy or for sale.

Family/Friends: Consent is not needed for photography done by the patient’s family members or friends. However, if a family member or friend has the consent of the patient to videotape a birth or procedure, this should be done only with the agreement of the attending physician and acknowledgement that the individual may be asked to discontinue taping if the attending physician deems it necessary.

Telemedicine or Internet Transmission: The general admission consent should be obtained before any photographs or other images are used in telemedicine or on the Internet. The images, along with the complete medical record, should be encrypted in order to protect the patient’s privacy.

Videotaping for Trauma Certification/Performance Improvement Purposes: Videotaping as a documentation “tool” for peer review, performance improvement activities, or trauma certification may be carried out with patient authorization; however, viewing is limited to authorized staff as per facility guidelines. The videotapes are not considered a part of the patient/s’ health documentation and will be erased following completion of the performance improvement process.

Patient Consent.

Generally, the patient/legal representative should give written consent before photography, videotaping, or imaging is carried out by anyone other than a friend or family member of the patient. Use hospital form “Consent to Photograph and Publish” form, NSG 09 (English or Spanish).

Storage, and Retention of Images.

Photographs, videotapes, and other images should be clearly identified with the patient’s name, identification number, and date. Medium should be stored securely to protect the patient’s confidentiality. If used to document patient care, images should be stored in compliance with the organization’s retention policy and state law.

Still photographs and scanned printouts taken for medical reasons may be filed with the patient’s record for safekeeping.

Sensitive images (i.e., photographs taken in the ER that are graphic or visually-assaulting, psychological therapy sessions that are recorded, sensitive diagnostic scans) need to be available for patient care, but also need to be maintained in a manner that protects the patient from unauthorized viewing. These images may be stored in sealed envelopes within the patient’s health record or other secure and restricted areas.

De-Identification of Protected Health Information – Photographs, Videotapes and Images.

Tehachapi Valley Healthcare District may determine that health information is not individually identifiable health information only if the following identifiers of the individual or of relatives, employers, or household members of the individual, are removed – including full face photographic images and any comparable images.

Reference:

AHIMA, Practice Brief: Patient Photography, Videotaping, and Other Imaging (Updated), 2002

Beta Healthcare “Risk Reporter”, January-February 2003