In medicine, photographs are an integral part of patients' medical records. They are ubiquitous in the hospital and have become indispensable. Healthcare professionals use them for a variety of reasons. For example, to follow theevolution of a skin lesion (chronic wound, surgical wound, skin disease, allergic reaction...); to keep a comparative history before and after a surgical operation; to aid diagnosis by zooming in on a lesion or asking a colleague'sopinion; to illustrate clinical cases for research and teaching; to constitute medico-legal evidence...
Some practitioners take more than 200 photos per week. This is the case of Professor Frédéric Bodin, plastic and aesthetic surgeon at the University Hospitals of Strasbourg. He is at the origin of the Pixacare application. He imagined the ideal management solution to take, sort, store and share medical photographs in an efficient and secure way.
Today, the solution is deployed in over 20 hospitals in France, including CHU Brest, Lille and Strasbourg. The managers and CIOs of these healthcare establishments chose to integrate Pixacare for three reasons:
Pixacare's medical photo library automates photo classification. Photos are instantly sorted by date, by patient and indexed with keywords. This benefits both the user and the hospital or clinic.
All photos taken from the application or imported are attached to a patient record. By clicking on the photo, you will find the following information: patient's first and last name, date of birth, PIN, associated keywords and a version of the photo with annotation if it exists. This way, doctors and nurses can find the patient history in an instant.
It is possible toexport a follow-up report containing all the photos taken for a given patient. For each photo, the date, the name of the caregiver and the associated keywords are indicated. This PDF file can be given to the patient and feeds into the DPI.
In France, there are still too many cases of incorrect patient identification. Misdiagnosis or therapy, exchange of inaccurate information, delays in treatment... The consequences can be serious and impact the health of patients. ANS recommends that identification processes be put in place to strengthen the reliability of identities collected at the point of care.
Before taking a picture, the application requires the user to identify the patient. The objective is to avoid data entry errors and duplicates in order to reinforce identity surveillance. Several options are available such as scanning the hospital label or identification via the GAM.
In fact, when Pixacare is connected in interoperability with GAM, it is not necessary to re-enter all patient information. The physician types in the PIN or date of birth and selects the patient from the list of admitted patients. The patient's data has been previously entered at the administrative reception.
A study published in the Annals of Aesthetic Plastic Surgery showed that surgeons saved time by using a smartphone app dedicated to medical photography. The goal of the study was to calculate the amount of time saved by the Pixacare app duringdata acquisition.
For the past twenty years, the method classically used in the plastic and maxillofacial surgery departments at the University Hospital of Strasbourg was the following:
With this method, the photographic data acquisition time was 259 seconds, or approximately 4 minutes and 30 seconds per patient.
By using the Pixacare application , this time has been divided almost by four to reach only 69 seconds. Indeed, the automation of the acquisition steps speeds up data collection:
The Pixacare app saves surgeons 3 minutes and 10 seconds per patient, or up to 1.5 hours for a day of 30 consultations. This saves valuable medical time that doctors can spend treating patients and performing surgeries.
In 2016, 85.9% of physicians used their smartphones for medical image capture. In 2019, they were 93% doing so. One can imagine that by 2022 this figure has increased further. From then on, securing the photographic data acquired by practitioners with a smartphone becomes a crucial issue.
The data storage system varies from one practitioner to another: smartphone, personal computer, professional computer, cloud, hard drive, USB key, memory card. Most of these are unapproved, unprotected media that can easily be misplaced.
Since the smartphone has become the most widely used tool for taking medical photos, there has been a scattering of images outside of medical records.
Often, even if it's only for a few days or hours, the photos end up being stored in the galleries of private phones. These images are mixed with family or vacation photos. In fact, 26% of physicians report that they have accidentally shown these images to their loved ones, thus violating medical confidentiality.
The advantage is that by using Pixacare, medical photographs are separated from the personal gallery and access to them requires secure authentication.
Medical photos are sensitive data. Their access is regulated by law. According to article 1111-8 of the public health code: "Health professionals or health establishments may deposit personal health data, collected or produced during prevention, diagnosis or care activities, with natural or legal persons approved for this purpose."
Decree 2018-137 of February 26, 2018 defines the rules for hosting personal health data. Health Data Hosting (HDS) certification is required for Cloud services that host personal health data. HDS certification requires service providers to adopt measures that ensure the security, confidentiality and accessibility of personal health data for patients.
The pictures taken with the application are directly hosted on an HDS server and are not stored on the phone.
The Pixacare application offers care teams two functionalities to strengthen their collaboration around photos: groups and secure messaging.
Hospital departments that use Pixacare have become accustomed to using the group feature to share their photos. Patient photo folders can be populated by all members of the department. Access to the groups is managed by the department manager.
The vascular surgery department of the hospital in Haguenau gave us feedback on the use of this feature. They have weekly meetings to review therapeutic cases and are used to putting photos at the center of the conversation. Since they have been using Pixacare, the organization of the meetings is easier and the meetings are more efficient.
The same is true for the plastic and maxillofacial surgery department of the University Hospitals of Strasbourg. They also use this feature to run their weekly meeting. Previously, it took the department secretary a day to prepare this meeting. She had to manually collect all the pictures taken during the week by 10 surgeons and 10 interns. Now she doesn 't have to prepare anything because all the photos are instantly available in the group.
95.3% of practitioners consider it essential to be able to send and receive photos on their smartphones. Yet, commonly used messengers like SMS, WhatsApp or Telegram are not secure enough to exchange sensitive data. For lack of a better alternative, they are often used by care teams.
The Conseil National de l'Ordre des Médecins, in its February 2017 report, recommends that "access to information that may be shared in records should be computerized, time-stamped and traced with traces kept in the computer system." The CNOM also recommends using a system that has a means of authenticating the healthcare professional with access to the messages.
Pixacare's internal messaging system allows for dating, tracking and retention of exchanges, while requiring users to authenticate with a password or facial recognition before opening the application.
The Pixacare application is the ideal tool to enable doctors and paramedics to use their personal phones safely in the course of care. This photo management solution is simple and ergonomic. It guarantees automatic labeling, implementation of photos in the medical file, perfect data security and easy exchange between healthcare professionals.
