Cell phone cameras create privacy issue

When it comes to sharing medical images, there's supposed to be a clear line between professional and prurient. But there are some gray areas, too.

As two New Mexico hospital employees recently discovered, taking camera phone photos of patients' injuries in an ER and posting them to their MySpace site is unprofessional and a firing offense.

More than a decade after a landmark federal law laid out the rules health providers must follow to protect patient privacy, glitches and downright outrageous violations still reveal personal, identifiable medical information. And hospitals and other facilities continue to find emerging technologies putting the information in jeopardy in new ways.

Electronic medical records may be a close second, but probably no single device has produced as much health privacy angst as cell phones that double as cameras, and cameras able to transmit the photos instantly, to boot.

The back-and-forth over the safety of cell phones around electronic medical equipment has been going on for years. The devices were most recently exonerated in a study by researchers at the Mayo Clinic, only to be fingered for causing myriad "incidents" in devices that including switching off and restarting a mechanical ventilator and stopping a syringe pump without setting off an alarm in a Dutch study, both published in 2007.

Still, the general impression is that today's cell phones and other personal communicators produce such a low electronic signature that they won't interfere with medical gear, but that there might be exceptions, particularly for older circuitry. Of course, another study, done in Ireland a few years ago, also found that 96 percent of all cell phones carried by hospital workers were contaminated with assorted germs, including several carrying antibiotic resistant staph strains.

Some hospitals ban phones outright, others bars use in sensitive areas, like ICUs, and others merely suggest that patients and visitors check with staff before making a cell call.

Patient privacy, not patient safety, is behind most recent restrictions on cell phones in hospitals. UCLA's neuropsychiatric hospital nixed all cell phones and portable computers after a patient was found to have posted group photos of other patients on a social networking Web site.

The same hospital fired or disciplined dozens of workers for celebrity medical file snooping last year.

Employees at Rady Children's Hospital in San Diego can't carry phones in patient-care areas after investigators found images of children, taken at the hospital, on the phone and computer of a respiratory therapist later convicted of child molestation and pornography charges.

Patient privacy - and no doubt concerns about adverse publicity, liability and security - is the reason that all hospitals, clinics, and other medical facilities have long-standing policies restricting photography, professional or otherwise. Stills and videos of childbirth and new babies are allowed, for the most part, as long as they don't interfere with treatment. Photographic record of Uncle Alf's gall bladder incision might or might not be well tolerated, but in practice, is hard to prevent.

Well over half of the more than 200 million cell phones in use in the United States now have built-in cameras. Most hospitals simply aren't set up to search visitors, much less staff, thoroughly enough to keep mobile phones out. Few of us with a cell phone would dream of taking a kid to the ER without it. And most of us would prefer that the doctors treating us have access to any and all electronic gadgets possible that might inform and improve what they're doing.

The downside is that institutional rules, even federal privacy laws, won't prevent occasional misuse of images captured with phones or other digital devices around a hospital. A little common sense and common courtesy would avoid most of them, though. People need to consider that anything snapped might be posted. And hopefully, when the docs talk about "the kidney in room 227" around the cafeteria table, the case review won't include photos.