Q & A explains new policies for consent to photograph

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Q&A explains new policies for consent to photograph

The medical privacy rules that took effect last month as part of the Health Insurance Portability and Accountability Act have prompted several changes in the Consent to Photograph form that patients sign if their photographic or electronic reproductions (including videotapes, motion pictures and/or electronic recordings) are to be taken. While the old Consent to Photograph form was quite broad - allowing the patient's photographic or electronic reproductions to be used for a wide range of scientific or educational purposes - the new form is much more specific, allowing only limited uses of these reproductions as specified under HIPAA. The following Q&A addresses key aspects of the new Consent to Photograph form and procedures.

Q. When should the patient sign the Consent to Photograph Form?

A. The purpose of this form is primarily to address state laws concerning right to privacy and intellectual property. The form should be signed by the patient in cases where the photos or electronic reproductions are not necessary as an intrinsic part of a procedure or treatment and
If the reproductions identify* the patient (see definition on page 6) and will be used for internal training activities or quality-assurance review, or
If the reproductions do not identify the patient and will be used for any purpose other than the patient's treatment or research.

Q. If the patient has signed a Consent to Operation form, does he/she also need to sign the Consent to Photograph form?

A. No, if the photographic or electronic reproductions are necessary as an intrinsic part of the procedure (as in laparoscopic surgery) and if these reproductions will be used only for SHC/LPCH internal training activities or quality-assurance review. If the reproductions are needed for any other purpose, however, a separate form may be necessary, as explained below.

Q. If I take pictures or electronic reproductions merely to track the patient's course of treatment (e.g. photographing a mole) and not as part of a procedure, does the patient need to sign a Consent to Photograph form?

A. Not if the reproductions are used only for treatment. Additionally, if reproductions taken for treatment purposes do not identify the patient, they can be used for internal training activities and quality-assurance review. If reproductions that identify the patient might be used for purposes other than treatment, it would be prudent to obtain the patient's consent.

Q. What if I want to use photos or electronic reproductions that identify the patient for a purpose other than treatment, internal training activities or quality-assurance review?

A. In this case, the patient must sign a separate HIPAA authorization form. The form can be obtained by contacting the SHC/LPCH Privacy Office, at 72-HIPAA (724-4722).

Q. What if I want to use the reproductions for research purposes?

A. If the use or disclosure is for research purposes, special rules apply, regardless of whether the reproductions identify the patient. For more information, consult the appropriate Stanford Institutional Review Board or access the IRB Web site at http://humansubjects.stanford.edu.

*A photographic or electronic reproduction is considered to identify the patient if it shows the full face or comparable image of the patient, or if any of the 19 elements of Protected Health Information are present. These elements are:

Physicians with additional questions about consent and authorization to photograph can contact Connie Taylor, SHC's patient care policy and procedures coordinator, at connie.taylor@ medcenter.stanford. edu or
(650) 723-8301, or Elizabeth Engel, SHC legal counsel, at eaengel@stanford. edu or (650) 724-3141.