An expecting new mother comes into your practice for a routine ultrasound exam. During the exam she pulls out her cell phone to capture a few photos and maybe a short video. What do you do?
As cell phone use has become ubiquitous, the AIUM has been receiving more and more calls and messages asking about cell phone use policies during obstetric exams. Practices are searching for guidance on how to set such a policy and what should be included.
To get a sense of how practices are dealing with this issue, last month, the AIUM sent a short survey to 1,652 individuals in 1,138 AIUM OB-accredited practices. Nearly 22% of recipients completed the survey.
According to the results, 88% said their practice does not allow videotaping during OB exams. However, only 51% said their practice has a written policy that supports this.
Why Have a Policy?
Those practices that forbid or restrict videotaping do so for a number of reasons. Some of the most commonly cited reasons include:
- It is distracting. Several respondents mentioned that having people videotaping is very distracting to the sonographers and physicians who are trying to conduct a medical examination. To help these individuals focus on medical care, videotaping is not allowed.
- Legality. In order to protect the patient’s medical information and staff identity, practices do not allow videotaping.
- Findings. When a sonographer or physician begins an examination, they do not know what they might find. To avoid the widespread sharing of unread studies or potentially personal information or decisions, practices ask that patients keep their phones off.
While nearly half of AIUM-accredited practices stated they do not have a written policy, there are several ways in which patients are told or asked to refrain from videotaping. Those methods include:
- Information in new patient packages
- Signs posted throughout the practice: waiting rooms, exam rooms, on the ultrasound machines
- Verbal statements from sonographers and physicians
Even using these methods, survey respondents acknowledge that enforcement is difficult because people still pull out their phones and hit record. Some practices do empower their employees by allowing them to stop the exam should a visitor not comply with the videotaping rules.
When Is It OK?
Of those practices that allow videotaping, most have rules about when and how it is allowed.
- Some practices allow short videos showing certain anatomy.
- Others state that patients can’t videotape staff or require that staff stay silent when patients are videotaping.
- In some practices, the sonographers and physicians use their discretion to control when and for how long videotaping can occur.
- Others allow unlimited videotaping after the diagnostic portion of the exam.
- Some practices will allow FaceTime (non-permanent) video during the exam but prohibit permanent videotaping.
- And still others are completely open and allow the entire exam to be videotaped.
Even among those practices that forbid videotaping, some may be allowed. The typical exceptions are for deployed parents or foreign parents of a surrogate. Many practices mentioned that they try to avoid the videotaping issue altogether by stating their policy and then following that by telling the patient they will supply some pictures or short video clips.
What can you do?
If your practice is looking to set a policy or even seeking resources to support your policy, here are some items that might help.
- Legal Counsel—If you are concerned about the legal aspect of allowing videotaping, or you are looking to set an official policy, seek legal advice and counsel.
- AIUM’s Keepsake Imaging Official Statement—This resource may help you in framing your policy, and it serves as a great document to share with patients.
- HIPAA—Several practices mentioned HIPAA compliance in their policies or statements as a reason for not allowing the use of videotaping during exams.
- Consent Law—In setting your policy, you may have support through your state’s consent laws.
In most cases, obstetric patients are not videotaping with ill intent. But as physicians and sonographers, there are legitimate and medical reasons to consider whether your practice should institute a policy on the use of videotaping equipment. While it can be a challenge to balance legal liability, best practice guidelines, and customer service, working with your staff, your legal counsel, and your customers, you can create a policy that works for all.