Last year on the Fourth of July, a night that's predictably busy for EMS and fire in most major cities, I was driving home with my two teenage children when a call went out for a nearby house fire. Never one to shy away from an emergency that's within a short driving distance, I proceeded to the scene.
About a block away, I could tell it was a "working fire" by the large glow in the night sky. I rounded the corner and saw a two-story frame house fully engulfed in flames. Being first on scene, I properly positioned my vehicle so I didn't block access for the engines and trucks that would be arriving. I also told my children to stay in the car (where they anxiously and safely watched all the action).
Within four minutes, fire crews arrived and started to knock down the fire, and I went back to my car. To my amazement, during the short time I had been out of the car, my children had clicked off countless pictures on their camera phones and e-mailed them to numerous friends. It took only minutes for images from this emergency scene to be transmitted all over the world.
The Real Picture
The public trusts EMS agencies to protect information about emergency scenes and patients, so the increasing prevalence of camera and video phones poses a modern challenge for us. As phones become smaller and less conspicuous, we must be ever diligent to minimize the potential for HIPAA violations. Some agencies haven't been diligent and have ended up in headlines and lawsuits.
For example, in 2007, a paramedic who worked for a private company was under investigation by the state ofKentucky for posting pictures of accident victims on his MySpace page. The EMS board didn't enforce any disciplinary action, however, because the company didn't have a policy about photos being taken on scenes.
Several months later, this same paramedic was assaulted by the father of a 16-year-old who was killed in a vehicle crash that the paramedic had responded to. The father, along with other family members, attacked the medic at the ambulance station days after the incident because witnesses said he took photos of the deceased boy, which the medic denied. According to news accounts, the father felt the paramedic had "crossed the line" by taking photos and didn't regret assaulting him.
Such accounts should activate alarm bells for EMS agencies that may be endangering patients' rights by not having clear policies. Do you allow the use of mobile phones? When and how? And who owns the images captured on the devices?
If you have a policy about scene photography, whether it prohibits photography altogether or not, make sure it's updated to specifically include camera and video phones. In addition, if your agency doesn't have a policy about general use of mobile phones, consider formulating one. It should specify when it's OK to speak on a mobile phone, as well as whether it's permissible to take photos and/or video and what can be done with those images.
If your station has bedrooms, locker rooms and restrooms, consider banning the use of mobile phones in these areas; employees have reasonable expectations of privacy in certain areas of the station, so you should be especially cautious and limit the potential of photographs being taken.
Some agencies don't allow the use of mobile phones at all. Although I don't agree with this kind of absolute policy, it would certainly prevent misuse of a camera or video phone. Other services have banned the use of cellular phones when driving an emergency vehicle or during the performance of any job function unless it's stated in the policy, such as talking with a doctor. On the other end of the spectrum, some agencies encourage employees to take pictures to show the mechanism of injury to the receiving hospital staff or to use for educational purposes.
Before finalizing the policy, be sure to seek legal consult. Once you've developed or updated the policy, make sure it's distributed to all employees and available for review. It's tough to take action against an employee for violating policy if they had no way of knowing about the policy.
Mobile phones that can capture photos and videos are becoming more commonplace, and this type of technology clearly has its advantages as well as opportunities for abuse. Because of these abuses, services should establish policies that protect theEMS agency, the patient and others from those who would exploit the technology.
As for the photographs my children took of that Fourth of July fire, I was lucky none of the images were of patients.
(Editor's note: For an in-depth discussion on what a photo policy should entail, read "At the Push of a Button," p. 84.)