Cellphone photos of surgery prompt inquiry

Cellphone photos of surgery prompt inquiry

URBANA — If you've had surgery at Carle Foundation Hospital, you signed a consent form that included an OK for the surgical team to take pictures of you during the operation.

Carle says the photos are to share with you, include in your medical records and sometimes for research and education purposes — not for what prompted an internal investigation recently: That is, surgery staff members sharing pictures they took on their own cellphones with other surgical employees because the injuries involved were so amazing.

In response to an inquiry by The News-Gazette, Carle Vice President of Surgical Services Stephanie Beever said Carle investigated three different situations involving pictures taken of surgical patients on employee cellphones last month.

Carle doesn't permit cellphones in surgery rooms or the use of personal equipment to take pictures of surgery patients, Beever said.

On all three occasions, the photographs taken had been requested by the surgeon involved for legitimate purposes, and Carle's authorized photography equipment wasn't working or available at the time, she said.

But during a subsequent investigation, Beever said, it was learned that some surgical staff members also shared some photos with other surgery employees on their cellphones, and some employees who saw the pictures weren't involved in the surgery or direct care of the patient, Beever said.

She characterized the sharing of the pictures as: "Isn't this amazing what we did to address this particular injury?"

Carle's investigation, which included the involvement of an internal compliance officer, has determined there weren't any patient privacy rights violated under the federal HIPAA (Health Insurance Portability and Accountability Act) law, Beever said.

"I hope we got a lot of people's attention," she said. "We have not breached anything at this time, but I don't want to wait until they do."

Patients coming in for surgery sign a consent form that includes acceptance of picture-taking by surgery staff and why it's done, she said.

However, Beever said, it's "absolutely our expectation that you don't use your own private equipment," she said of employees.

Carle provides equipment for those pictures, she said, but on one occasion, a camera didn't function properly, and on two occasions, the cameras couldn't be located. So employees used their cellphone cameras.

"They were pretty significant injuries, and the surgeon was moving the procedure along," she said.

Since the investigation, Beever said, there have been patients notified about what happened concerning their surgery pictures.

None of the patients were upset about it, she said, adding, "they also were amazed at their injuries."

Beever said Carle has taken steps to educate employees on policies relating to photographs and the use of personal equipment, and that was continuing as of Friday.

A back-up system for surgical camera equipment has been put into place, and an existing ban for staff on cellphones in surgery rooms has been reinforced, Beever said.

It's not just about picture-taking. It's about all the potential distractions that cellphones can cause someone involved in a surgery.

"We don't want folks being distracted," Beever said.

Presence Covenant Medical Center also asks patients to sign a consent form for photography during surgery for medical and scientific purposes, provided their identity isn't shown, and patients have an opportunity to opt out if they want, hospital spokeswoman Crystal Senesac said.

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Danno wrote on June 15, 2013 at 9:06 am

No mention of the well studied and documented fact that a cell phone is amongst the most unsanitary objects on the earth; beyond a toilet, more in the ranks of keyboards, door handles, et. al. Oh well, just another minor, pesky risk, I suppose. Don't worry about it Danno.

Shiofra wrote on June 15, 2013 at 10:06 am

"Carle's investigation, which included the involvement of an internal compliance officer, has determined there weren't any patient privacy rights violated under the federal HIPAA (Health Insurance Portability and Accountability Act) law, Beever said."

I personally find this to be debatable, having worked in health care for the past ten years and completing annual HIPAA refresher training.  The 'Minimum Necessary Requirement' clearly states "...protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function."  That being said, in what world is "Hey, check this out!" in any way 'necessary' information for the recipient?  

Of course the rule goes on to state "...the covered entity always retains discretion to make its own minimum necessary determination for disclosures to which the standard applies."  I suppose this gives them an 'out' to twist the events into any sort of "educational opportunity" they want to legally get away with the breach in protocol.

Let this be a lesson, surgical waivers should always offer an opt-out for things like photographs, and individuals should be more discretionary as to what they agree to.

Commonsenseman wrote on June 15, 2013 at 2:06 pm

If the doctors saved my life they can take whatever pictures as long as its not of my privates and face.  The real problem here is that this is being made into a "big deal" which its not, obviously someone at Carle "reported" this situation which means their unit integrity and comaraderie is poor.  I heard Carle fired my previous doctor because he thought it was stupid to have him type in my name address and insurance info instead of hiring a secretary to do it.  Apparently Carle wanted to save money buy having him type instead of being a doctor.  They fired him for saying this. They have an adminsitration that my new doctor said treated them like slaves. I want my doctor to be happy treating me not being a sweatshop worker.

Danno wrote on June 16, 2013 at 8:06 am

It is a 'Big Deal'. Are you aware of why hospitals around the nation seriously clamped down on post surgical recovery room visitors (including Carle)? Gee, let's guess; Bacterial Infection? Wound Dehiscence? Et. Al.? Ever experience the difficulties encountered when you/a loved one/mother-father in-law/others close, whose post surgical recovery time is extended, perhaps, four-fold due to the above? Perhaps they were older, never fully recovered, then...well; full time nursing care for the remainder of life or, death. No big deal. Huh.

WOW wrote on June 15, 2013 at 2:06 pm

They probably got found out when they billed the patient's insurance for a $5,000 I-Phone Scan "lab".

Bulldogmojo wrote on June 15, 2013 at 7:06 pm

Dear Carle medical staff, Just speaking for myself...

If I am so seriously injured that you as a medical professional feel compelled to take a picture with your smartphone for the sake of "Hey this injury is one for the record books" then I ask you,  will you please PUT DOWN YOUR PHONE AND HELP ME?!

Marti Wilkinson wrote on June 15, 2013 at 7:06 pm

If the equipment is not working, then don't use it. As another poster noted, I would be concerned about having something as unsanitary as a cell phone in an operating room. I can understand the use of camera's for educational purposes, or to let a patient see what was going on medically. When I had surgery for endometriosis, the doctor did furnish me with some pictures. Later for cancer surgery, I wasn't given any photos of the breast cancer tumor that was removed. Some things are better left to a pathology department.

TruthMatters wrote on June 16, 2013 at 8:06 pm

Carle really knows how to spin their mistakes. Maybe their administrators should opt out of the medical field (as they're doing such a bum job) and join forces with the dirty politicians this states produces. In what world is this an acceptable error? And moreover, saying that the patients were fine with it does not negate that what was done was completely wrong. The patients may not even understand what HIPAA compliance means. And I'm sure whichever Carle rep called them to explain sure as heck didn't tell them that a breach was done. Give me a break. It's ok to double bill patients. It's ok to mandate that they have their pictures taken in vulnerable states. It's ok for them to then share those photos among employees. Which by the way... how do they know those same photos... on PERSONAL cell phones... didn't make their way back to family or friends? Can they GUARANTEE that didn't happen? I highly doubt it. So to sweep this under the rug and minimalize its impact only enforces the idea that operations at Carle aren't exactly ethical. At least Presence Health allows for patients to opt out of being photographed. No surprise that Carle doesn't seem to heavily favor that. 

Commonsenseman wrote on June 16, 2013 at 10:06 pm

as for my "big deal" comment dont get me wrong, I dont think this is a good idea,  the fact that someone reported it is a big deal, because it means you cant trust your coworkers, and thats a problem.  Hard to work in a place where  people will stab you in the back.  I heard on the radio these administrators that deal with this stuff make more than doctors and nurses, that scares me more.  I'm sure if you consent to pictures they might take them and share them.  i agrree if they dont have the right equipment taking a cell phone shot seems a little ...dirty and voyeuristic to me

wdlandsaw wrote on June 17, 2013 at 7:06 pm
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The person who reported it should be praised, reporting someone for doing something unethical and against policy is the moral and correct thing to do.  As for working in a place where people will stab you in the back, well that's everywhere I've ever worked over the last 45 or so years. 

rsp wrote on June 17, 2013 at 8:06 pm

You're more concerned about people keeping their mouths shut and covering up illegal activity than the fact that patients were violated? You have no idea what was photographed and shared. Cell phone pictures have data in them that can be traced to time and location, which means they can put a face to the pictures. They may already be up on facebook. And that's okay with you?

Commonsenseman wrote on June 19, 2013 at 12:06 am

I really dont care if my picture ends up on facebook as long as my face and private parts arent in them, yes I do think its petty someone there ratted on their colleagues.  I dont know much about the medical profession, my niece is a nurse there she works on some tower there and from what she tells me its like a soviet system there. She hates it and wants to quit but needs a job.  Like I said before they fired my doctor for not typing stuff the way they wanted him to. He was a good doctor.   My niece told me they fired another doctor because he was busy talking to his girlfriend and didnt want to do what a nurse"told" him to do quickly enough for her. The doctors there get no repsect there according to her and thats why they hire lots of doctors from foreign countries, nobody else wants the low pay, the monitoring of their time and the lack of respect. The doctors hate the administration there is what my niece told me. She told me the big adminsitrators make all the money and everyone is afraid of them. I'm afraid to get sick in this town.  I especailly hate the fake overly respectful attitude they give me,  the yessir nosir routine, I couldnt stand  the doctors they have sucking up to me and acting so "caring".  I knew it was fake  before my niece told me.  I just want a smart doctor, I dont need some fake actor. Take all the pictures you want if the doctor says so, just save my life.

tylerra wrote on June 19, 2013 at 9:06 am

Isn't an operating room a sterile environment, I don’t think a cell phone would be sterile.

rcraig wrote on June 21, 2013 at 8:06 am

Photos that I take with my Android phone are automatically backed up and are download to my Google+ account.  Even if I delete a photo from my phone, the file still exists in my personal account that I can access from anywhere.  Many people use this feature with their phones.  Has anyone looked into whether these images have left the facility in this manner?