Clinical Photography

It didn't come as a great surprise to our clinical photographers to learn that the number of patients photographed in the year 2013-14 has shot up by 17% over the previous year.

Everything just seems busier than before and the statistics prove it – a 30% increase in the number of plastic surgery cases photographed, big increases in dermatology, maxillofacial and ophthalmic imaging. So why is this happening and what do  these specialities have in common that makes them such big users of photography?
Clinical photographs are taken for a variety of reasons. The most obvious, perhaps, is that photographs of clinical conditions are needed for clinical teaching, since one of the most important diagnostic skills a clinician can have is the ability to recognise clinical features, such as the picture here of Dupuytren's Contracture. Photographs are also used as illustrations in published case reports, textbooks and online resources such as e-learning packages. But, overwhelmingly, the vast majority of clinical photographs are used as an integral part of the patient's monitoring and assessment.
The modern multidisciplinary approach to medicine makes accurate, objective images an extremely valuable tool, alongside all the other clinical information recorded for each patient. Photographs allow everyone in the team to see the clinical features of a case at all stages of diagnosis, treatment and management. 'A picture is worth a thousand words' is an irresistable cliché here, because it goes to the heart of the reason that images have become so important in medicine. No amount of description could replace a photograph for a dermatologist who is trying to assess skin changes in an eczema patient he hasn't seen for several weeks. A high-quality photograph can be enough for a  dermatologiost to diagnose a malignant melanoma, or to identify on a mole map which moles have been scheduled for excision. In cleft lip and palate surgery, photography is used to audit surgical outcomes. In plastic surgery and maxillofacial surgery preoperative photographs provide an essential reference during a surgical procedure. It's also often useful to take photographs during a surgical procedure for later review. In ophthalmology the visualisation of pathology in the structure of the eye is used in all aspects of treatment and in 2013-14 Media Studio undertook over 14,000 individual ophthalmic tests.
At CUH we have a well-established Clinical Image Library, which is accessible by clinicians from anywhere on the Trust network. It will also be linked from the new eHospital system when it launches in October this year. With over 20,000 patients photographed this year we're having to look very closely at every aspect of our workflow and how it fits into the patient's journey so as to avoid becoming overwhelmed by the volume of requests at the expense of both patient experience and staff morale. The increase in volume is a real challenge, but in meeting it we will not allow quality to be compromised. In the 2013 Institute of Medical Illustrators Annual Awards, our clinical photographers between them won no less than twelve awards for their clinical photographs. More importantly, those 20,000 patients are benefiting from their doctors and other clinical staff having access to high-quality, standardised clinical photographs to help in their clinical decision-making at every stage of their journey.
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