Simple Tracking System (STS) often receives questions about the legality of utilizing facial photos during disaster operations. In short, utilizing facial photos is legal as a medical record identifier and is a medical best practice in significantly reducing errors. Below is additional information on this topic for your consideration:
Legality
It is legal to take someone’s photo without express consent during a mass casualty (e.g., the patient is unconscious) when the incident takes place in a public place (street, festival, concert, school, etc.). If the incident takes place in a non-public location and there is an expectation of privacy (home, hotel room, bathroom, etc.) then you cannot take a picture without permission.
In the use case for STS, mass casualty incidents occur in public areas where there is no expectation of privacy. Thus, there is no law limiting photos in these cases. Public safety and security use public photos all the time for identification purposes.
Health Insurance Portability and Accountability Act (HIPAA)
In the use case of STS, the facial photo is protected health information and is thus HIPAA protected. Additionally, the responding public safety or medical entity is considered to be ‘a covered entity’ by the HIPAA Privacy Law so must have practices and systems to protect this information from disclosure. This means that the picture cannot be shared outside of the limitations of the HIPAA Privacy law. The picture can only be shared or utilized when used for treatment, shared with physicians or medical personnel involved in the direct care of the patient, or notification, shared in order to properly identify, locate and notify family members, guardians, or anyone associated with the care of a patient in a disaster situation.
STS utilizes technology and practices that are HIPAA compliant. We take patient privacy very seriously and have designed our technology to be effective and efficient without compromising patient privacy.
Medical Record
The responding public safety agency or medical personnel uses the facial photo as part of a patient medical record within the STS system. The facial photo is an important part of the record to ensure proper identification and registration of the patient. Similar to showing a driver’s license or official identification at the hospital, STS uses pictures to ensure that you are who you say you are and to ensure that you are not confused with another patient. Many medical entities are now using a photograph as one of the two medical identifiers. This practice helps hospitals decrease medical errors related to patient misidentification and is a medical best practice.
Your face is a very effective identifier – it belongs to you and you alone so it’s a great way to ensure we know who and where you are!
Patient Refusal
Most patients refuse to have their photo taken because they do not understand the purpose.
If the patient is unconscious or altered and incapable of making a medical decision, the photo can be taken without express consent as explained above. Additionally, like most medical procedures, the picture is part of the medical record and ethically can be taken under implied consent for medical care.
If the patient is awake and capable of making decisions, explain that the photo is part of the medical record for identification purposes and for family reunification. Explain that the photo is how STS tracks location within the medical system so officials can ensure that family and friends can locate them. Also mention that the picture is part of the official medical record documenting patient location and is protected under the HIPAA Privacy Law just like any other part of the medical record.
If a patient refuses to have their facial photo taken all together, we advise users to take a photo of their official identification (driver’s license or ID card) to have pertinent information captured and a photo on file, although the image matching technology is not as accurate when an image of a photo is used. Users can also capture photos of any unique features on the patient, such as a tattoo, birth mark, scar, or other marking that is unique to them. Image matching technology matches any similar images not just facial photos.
The database of patient records is still useful to an agency even if a facial photo is not attached to the patient’s record. Users can search the database by any data field (name, DOB, destination, triage level, etc.) and patients can be identified and located via the search method in addition to image matching.
STS technology should be used with consent if at all possible. Patients almost always give consent if an explanation is provided, explaining that the photo is for identification purposes as part of the patient’s medical record. As part of a medical record, the photo is protected by the HIPAA Privacy Law.