BT26 Safe use of mobile photographic devices in dermatology: a multicentre quality-improvement project

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Abstract Mobile devices are increasingly being used in dermatology to take clinical images, particularly in settings where medical photography services are not readily available. Healthcare professionals are expected to use mobile technology safely to improve patient care. Published UK guidance on the use of mobile photographic devices in dermatology details standards in three key areas: gaining patients’ informed consent, safe use of mobile devices to capture patient images, and safe transfer and storage of these images. A quality-improvement project was conducted across three UK centres. Baseline data were collected over a 2-week period in January 2023 using an anonymous staff survey and analysis of 50 outpatient encounters where mobile devices were used to take clinical images. Our survey achieved a response rate of 77% (n = 20) from consultants (60%), specialty doctors/fellows (30%) and nurses/advanced care practitioners (10%). All respondents sought patient consent prior to taking images on their personal devices, with only 10% using written consent forms (remainder using verbal consent). Thirty-five per cent reported always documenting consent in patient notes and only 20% discussed the risks and benefits of using mobile devices to take patient images. Eighty-five per cent used devices with strong passcodes (six or more characters), but only 50% confirmed that data encryption was enabled on the device. Thirty-five per cent disabled cloud-based back-up systems, 55% disabled Bluetooth and only 5% switched off global positioning system information before taking patient images. For image transfer, 80% used NHS.net email and 20% used a secure clinical image transfer application. Seventy per cent confirmed using a secure network server for image storage and that they always removed patient images from their device after transfer. Analysis of 50 patient encounters revealed that verbal consent was only documented in 8% of cases and a discussion around the risks and benefits of using mobile devices was not documented in any case. National guidance states that it is the healthcare professional’s responsibility to give patients clear information on the risks and benefits of using mobile devices to capture and transfer clinical images for storage, without which there is no informed consent. Our findings highlight a lack of awareness and adaptation of practice to these standards. We will ascertain reasons for this and implement interventions to meet guidance, including an educational meeting and introduction of a standardized written consent form to ensure patient safety and appropriate informed consent. We will present our findings on the impact of these interventions following subsequent rounds of data collection.