Social Image-sharing Apps Exposing Patient Information

Patients, employees, and radiologists are sharing more than ever of their lives online. With the proliferation of smartphones, cameras, high-speed Internet connections and photo-sharing services, life’s moments can be broadcast in real time to friends, strangers, and the entire world.

Social photo sharing is already a part of radiology, whether you are aware about it or not. Instagram, a mobile photo sharing app, allows users to take pictures on their smartphones and post to the entire world. Facebook recently bought the company, which does not generate any revenue, for $1 billion. This image sharing will surely begin to cause security and privacy concerns and damage reputations. A few simple searches on Instagram yielded some fascinating discoveries.

I did a search for #xray this morning. There are 22,238 pictures about X-rays posted on Instagram.

Here is one user who took a picture in her physician’s office of her X-ray. She has 411 followers and received 22 “likes” on a picture of the X-ray of her elbow with the caption “My badass implants.”

Notice in this image she even captures the patient ID, Name, date of birth and date of service (which we’ve blacked out here). She had no security associated with the image - it is open to the world. She even tagged the image #xray, so that other Instagram users could search and discover her picture.

Even celebrities, or well-known people, are sharing their medical images. A DJ who broke his foot near the end of the tour took a picture in a physician’s office of the X-ray and posted it online. More than 98,000 people follow the DJ’s images, 4,019 people “liked” the image, and 284 people commented on the image.

Easily visible is also the date of birth, date of service, and patient ID (again, we’ve blacked out that information). In fact, one user noticed the date of birth, and commented, “Youthful and gorgeous Ryan Raddon is born in 71?”

So posting images of the implants in your knee and a broken foot on a tour may not be really private images. But, what about posting a picture of your mammogram? Is that something that a patient would want to share to friends and the world? 

In some cases, yes. One user posted the image and commented: “Hey everyone, look at my boobs !! All good inside.” And tagged with #mammogram to make the image searchable to all Instagram users.

So, a patient is posting images of her own mammogram. That is her choice.

Unfortunately some employees are also posting images of patients’ breasts. See below, one user posts an image and says, “Yeah I get to see boobs all day at work.” He tags the image with #mammogram #work #digitize so that anyone who is searching by those terms will see this image.

What is particularly disturbing is that the picture captures the patient’s name (yep, we blacked out the information here).

This is the new reality. There is no going back. It remains to be seen how this new reality impacts patient privacy, malpractice and reputations of hospitals, radiology groups and radiologists. But it will.

David Fuhriman is CEO of Bern Medical, a data specialist company. Bern provides dashboard reporting to iPad/iPhone, billing audits, and other data analysis services.