TechTool Thursday 023

TechTool review of PicSafe Medi by PicSafe on iOS  and Android 

There has been much discussion online with #foamed supporters interested in a mobile app that consents for taking patient photos.  While we were all chatting about it…someone else has done it.

PicSafe Medi offers a secure way for you to take patient photos and record consent.  It’s fabulous.  But not exactly free.

Website: – iTunes - Website - Android

Design

  • The app looks beautiful and works perfectly.  It’s clear that a lot of time, effort and money has gone into making this app special.
  • The developers have set up a company specifically for this app and it must have had a decent amount of financial backing.

User Interface

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Clinical Content

  • This app has very simple functionality: you take a picture; add whatever details you want to it; record consent from the patient; and upload the image to your archive.
  • The archive of your images are not stored on your phone but on PicSafe’s secure servers.  You can access them any time from your phone, or directly on their website, by logging into your (password protected) archive.
  • If you want to share the photo with someone else then you can send them a link.  They will also have to sign in to view the image.
  • Images are stored for 7 years.
  • And that’s it.
  • Simple but delicious.

Cost

  • There is a free 30-day trial and then you have to pay a rather extortionate $19.99 per month

Room for Improvement

  • The price is really aimed at institutions and is completely over-the-top for individuals.
  • It would be good to know more info about the ‘patent pending’ that they have – are they really patenting an app that stores photos securely (seems unlikely)?
  • You cannot edit the consent in order to add specifics about your website usage so we are stuck using their default consent.  However you could record them consenting for your website with the audio record function

Overall

As you can tell, I love this app.  It’s what we’ve been looking for and I couldn’t have designed it better myself.

It’s not exactly designed for bloggers, but the app can be adapted to suit our needs.  For uploading to websites/blogs you would need to copy the photo onto your phone and then upload it from there – this, of course, does negate the whole security issue (but I guess you could delete it from your phone immediately).

Ideally we’d use PediSafe as a basis for designing a FOAM app – but without more details of the patent-pending this isn’t an option at the moment.

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Comments

  1. Ted Carner says

    Hi Tessa and thanks for the review.
    As we are “just docs” who have spent a significant portion of our embryologic developments in overseas, “third-world” (hate this term but communicative) settings, we have little idea re: pricing of the PicSafe app. The app, or something like it, simply “needed to be done”, as you aptly point out.
    The public health institutional was the planned “paying customer” to help us recover our considerable personal outlays on the design and build of the app. That, as you likewise correctly point out, is the basis for the “rather extortionate” monthly pricing.
    This is under review (I’ve never felt good about the pricing and have pushed for a totally free status to all training docs and any public health docs for starters).

    As a doc, I would personally very much appreciate your input(s) on this particular detail.

    Thanks kindly,

    Ted Carner

  2. says

    Dear Tessa,
    Thanks so much for taking the time to review the app that I have been involved in developing. I am a clinician and along with a couple of colleagues (Ted Carner and Heather Cleland) we had been talking about this problem for the last couple of years. We have done some heavy duty reviewing of the literature around the issue, and have also analysed the legal aspects, particularly as they apply to Australia and the United States. The app has been designed taking in all of the Australian Privacy Law issues and the Patriot Act. We also believe that the app is HIPAA/HITECH compliant.

    The solution is not just about the app, but rather the backhand web features (on any device) that we are particularly happy with. The images are securely stored in a high level secure facility which is compliant with Australian regulations. The ability to archive and securely share and download consented images into medical records is one of the features that we have worked hard to achieve. We understand that the pricing may be an issue on first inspection, but unfortunately the Cloud is not free. In addition we have made it an unlimited service and have include an array of security, search, and archiving features. We conceded that we may have to review our pricing if it is a significant barrier for uses but have kept it as lean as we can to make the project viable. As I am sure you are aware, there is some pretty heavy fines coming next year for Doctors and Organisations who are in breach of the new upcoming National Privacy principles that have been recently legislated.

    Thank you again for reviewing the app and we look forward to further feedback.

    Best wishes, David Hunter-Smith

  3. says

    Great review Tessa and congratulations to the design team on a great app.

    Tessa and I have been discussing the design of an app similar to this for educational use. As I’m sure David and Ted know more than anyone else, there are significant legal hurdles to overcome and that is where we’ve largely stalled (how do you get an expensive legal opinion when you are designing an app that we want to be cheap enough for all doctors to use).

    The one thought I had re: the legal aspect was the use of the in app consent to bypass this. If the patient consents for the use of the picture (appropriately de-identified) to be used for educational purposes, does this not imply a waiver of privacy? And the picture is not being used for medical management so there isn’t the need for the 7 year storage issue.

    I wonder (this is thinking out loud) -- if Pic safe could offer an ‘education’ version, that has an appropriate consent, without the photo storage and an API to link the picture to a photo editing program to help de-identify the image -- you could offer the program (with the appropriate disclaimers) to those wishing to take photos for educational use only, expanding your customer base to include the individual clinician .

    The other issue is, as Tessa brought up, the patent pending. Is Picsafe’s patent going to restrict someone from designing an app as I described above? That would be a terrible shame if so. I guess we wait and see.

    • Tessa Davis says

      Yes Chris, if PicSafe Medi could do an educational version without storage costs that would be excellent. Ted and David -- would you consider this?

      You are right about storage not being needed but I’m not clear on what you mean re privacy and legal hurdles. If you’re storing the consent info on your phone then won’t this be linked to the patient details and photos and therefore require the security measures?

      Would be good if Ted and David could give the details of the patent pending.

      • says

        Not necessarily (as you might gather, I’ve been overturning this in my brain a bit) .

        The consent (lets say its a signed form you take a pic of, or signed digitally on your phone) only has date and signature, with a randomised identifier (similar to a hospital number). This number could be given or emailed to patient and if they want to later withdraw consent, they would email you that ID and the images (saved under that ID) could be removed.

      • says

        Thank you so much for the ongoing discussion.

        Yes we have spent a small fortune on legals -- having commissioned a detailed report around all of the issues from major legal firms in Australia. We have also had independent medico-legal opinons from both the private and government sector that confirms that we are on the right track.

        The concept of a cut down version doesn’t make sense to me because as clinicians it’s the day to day cases that we most often want to use for education -- rather than the odd case for publication. The is also the issue of whats de-identified (too hard).

        Picsafe medi ticks off all of the boxes that it seems you want, however the cost seems to be a barrier. I suspect that when the proposed 2014 fines attached to the legislated Australian Privacy principles start rolling out it may be more attractive!

        We didn’t start this process to rip anyone off….quite the opposite, It was very much more about creating a solution to a problem that would gives us all more safety and certainty. What we have developed is so much more than a simple app -- try out the archive searching etc. as well as the downloadable PDF’s.

        We are meeting as a development group later this week to discuss pricing as we don;t want it to be a barrier for use.

        What price do you think will hit the market? ie number of images for how much (full service)

        cheers and please let me know you thoughts

        David HS

        • says

          Thanks David.

          Perhaps users could pay in proportion to what they actually use? $19.99 per month covers dropbox storage for my entire life’s works. But if I was storing enough pics to merit that then I’d be happy to pay it. Could you charge in proportion to storage space (i.e. users could in-app purchase storage space)?

  4. says

    We will look at all options.
    The cost to process an image, and then store it securely for a minimum of 7 years will determine the cost.
    Do you think something like $X per month or year for X numbers of images would work, or would you prefer a $X for X GB of storage sytsem??
    David

    • says

      If the 7 years is making the cost too much then could users just have the option of paying for one year’s storage at a time? I don’t think it matters whether it’s per month or just to buy some storage. The idea is just that users would be paying in proportion to how they are actually using the service.

      • says

        Is the 7 year storage requirement necessary though? What I mean is -- my understanding was that the 7 year storage was for clinical photography used as a part of the patient’s record. If the picture is taken exclusively for education -- does it need to be stored thusly?

  5. says

    Thanks Chris and Tessa,

    If you want images for educational purposes, with no consent and not available in the EMR and through FOI then you can use any old system …. picsafe medi offers more though ..

    We have listened to you, reviewed our costs and reduced them to the bone -- $50 a year for the full service (unlimited photos) with registrar trial of 180 days ..

    I hope this helps -- please give it a run and let us know what you think..

    There are a bunch of new features about to be added which wil make it even better!

    thanks for your feedback -- we have listened

    dhs

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