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The Uses of the iPhone for the Plastic Surgeon

Friend or Foe?

Amin, Kavit M.B.B.S.; Chandrasena, Amali

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Plastic and Reconstructive Surgery: February 2012 - Volume 129 - Issue 2 - p 408e-409e
doi: 10.1097/PRS.0b013e31823aeefa
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We would first of all like to recognize the articles centered on iPhone (Apple, Inc., Cupertino, Calif.) technology and its use in plastic surgery. We read with interest the articles entitled “A Virtual Surgical Amphitheater: Using Technology to Allow Medical Students and Residents to Observe Operations Anytime, Anywhere” (Plast Reconstr Surg. 2010;126:324e–326e) and “Augmented Reality in Oculoplastic Surgery: First iPhone Application” (Plast Reconstr Surg. 2011;127:57e–58e). Although the benefits of such technological progress are evident, the issue of confidentiality warrants attention. Augmentation using mobile technology has recently been gaining popularity, but using real-time imaging has the potential to be stored on an iPhone and can be troublesome if not regulated, especially if targeted toward medical students, still undergoing training on confidentiality at medical school. One study found that one in 10 U.K. medical students exhibited frank violations of patient confidentiality on social networking applications and mobile applications.1 Furthermore, digital images taken using iPhone's camera taken in operating rooms and the emergency department can be stored on the device, which may be taken without patient permission. In 2004, the General Medical Council described the importance of appropriate arrangements for the security of personal information when stored electronically. The General Medical Council states that patients have a right to confidentiality.2 Furthermore, trust between doctor and patient is central and is something that has been a privilege for centuries to those practicing medicine.

All personal identifiable data are regarded as protected by the holding organization, which has a duty to enforce confidentiality. In the United States, the privacy rule of the Health Insurance Portability and Accountability Act of 1996 was enforced in 2003 to protect health information to maintain confidentiality.3 In the United Kingdom, there are no specific laws governing mobile handset use and patient confidentiality, but we currently have a legal requirement determined by common law, the Data Protection Act 1998 and the Freedom of Information Act 2000. Data that are regarded as confidential in nature are protected under the notion that the confidant (doctor) can disclose information only with consent from the confider (patient).4 The National Health Service is required to also abide by the National Health Service code of practice for confidentiality. There are six Caldicott principles related to transferring and collecting identifiable information. These principles govern the use of patient information, and every health professional using it needs to be aware of it. We must also consider the legal risk to health care trusts that do not make adequate attempts to prevent medical identity theft. Medical identity theft includes identifiable information, which can include birth date and patient addresses. Information can be sold to other parties or used for other fraudulent purposes.5 We embrace the emergence of mobile technology for surgeons, provided that there are more concise laws governing the use of mobile technology in the workplace. With the introduction of the android operating system and the surge in application developers, the future impact remains to be seen.4

Kavit Amin, M.B.B.S.

Amali Chandrasena

St. George's, London, Sheffield, United Kingdom


The authors have no financial interest to declare in relation to the content of this article.


1. Leach B. ‘Tweeting’ breaches patient confidentiality. The Telegraph [cited 2010]. Available at:
2. General Medical Council. Guidance for doctors. 2006.
3. Pancoast PE, Patrick TB, Mitchell JA. Physician PDA use and the HIPAA Privacy Rule. AMIA Annu Symp Proc. 2003:962.
4. Haynes CL, Cook GA, Jones MA. Legal and ethical considerations in processing patient-identifiable data without patient consent: Lessons learnt from developing a disease register. J Med Ethics 2007;33:302–307.
5. Mancilla D, Moczygemba J. Exploring medical identity theft. Perspect Health Inf Manag. 2009;6:1e.


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