Authorities caution against use of digital cameras, mobile phones in telemedicine

U.K. doctors are learning to think twice before using cell phones or digital cameras to capture and relay medical images for remote diagnosis.

New guidelines follow media reports of the technology being used in telemedicine schemes and medical emergencies. One report claimed accident and emergency doctors were using photographs of crash patients' injuries, relayed from the scene by picture messaging, to prepare for casualties' arrival. Another report alleged orthopedic consultants were using mobile phones to digitize and transmit musculoskeletal x-rays for second opinions.

Regulators responsible for medicines and healthcare products (MHRA) have issued a warning to public health sector employees about the risks of using off-the-shelf technology for medical purposes. Because neither digital cameras nor picture messaging mobile phones are designed for medical use, the diagnostic value of images they capture is unknown. Acquisition and transfer of digital x-rays using such devices could expose patients to unknown and unacceptable risks, according to the MHRA.

"Our concern is over the risk of misdiagnosis from such low-quality images. This may have legal implications if incorrect or insufficient treatment results," an MHRA spokesperson said.

A leading U.K. medical defense organization is urging its members to heed the regulators' caution and be aware of potential legal and ethical pitfalls. A guidance released by the Medical Defence Union stresses the need to maintain security of medical images transmitted by picture messaging and gain a patient's consent before photographs are taken or shared with colleagues in remote locations.

"We recognize that this technology is being used by doctors, and that its use can be of benefit to patients," said Dr. Nicholas Norwell, the union's medicolegal adviser. "But doctors must be aware that the images are medical records, which are subject to all sorts of legal and ethical safeguards."

The temptation to transmit digital photographs from accident sites to A&E units is understandable, though any radiological images transmitted by picture messaging would be far from diagnostic quality, said Dr. Keith Foord, secretary of the Royal College of Radiologists PACS and Teleradiology Group.

"It is of course very easy to do, and one can appreciate the temptation to take this shortcut," he said. "But the images could go astray or end up on some unsuspecting person's videophone if the number was misdialed."