I'll admit it: I love cameras.

I'm the guy that buys (and actually reads) the geeky magazines about new camera gadgets. I go to camera stores just for fun. And I've been known to bring a 15-pound video camera to my children's school plays.

Plus, as a surgeon, I've found medical photography to be a crucial part of my practice. Since the '70s, I've used photos to show patients their progress, teach medical students, and support my own learning and progress. And once we started experimenting with telemedicine and medical collaboration -- eventually founding ClickCare -- photos became not just helpful, but a fundamental part of what it means to practice medicine. I've found incredible satisfaction and powerful patient outcomes from using telemedicine to send simple photos and collaborate with other providers.

Because of my passion for using photos in medicine, I'm sometimes tempted to search out the best or most high-tech cameras for medical and clinical photography. The truth, however, is that you don't need a fancy camera to take great and effective medical photos.

When someone asks about the best camera for medical photography, I recommend 3 things:

1. Use your iPhone. Most of us have a pretty high-tech camera in our pockets at all times-- our smartphone. Because of the convenience factor alone, I recommend that medical providers start taking pictures with their iPhone. In addition to the convenience, ease of use, and ever-improving quality, the connectivity of these devices makes it incredibly easy to make the small jump to medical collaboration with telemedicine. However, the is one very big caveat here. Saving pictures on your camera's camera roll is not HIPAA-secure. So you need to use a platform like ClickCare that allows you to save photos on a separate, HIPAA-secure, protected camera roll.
2. Use whatever you already have. If you don't have a smartphone with a camera that you use regularly, my next suggestion would be to use whatever camera you do already have. Maybe it's your daughters snap-and-shoot or the camera of a provider down the hall, but I suggest using what you have, getting in the habit of taking pictures, and then using that experience to decide if you want to upgrade. Remember that one place a patient's health information can be exposed is on the card inside your camera, so that should be treated with the same care as you would a patient's record.
3. Use whatever is easiest. Finally, I encourage everyone to keep it simple! Instead of getting a 1% increase in photo quality by spending $3,000 on a camera and taking 3 full weeks to learn how to use it, choose a camera that feels easy and accessible. The important thing is using medical photography in your practice -- not necessarily taking gallery-ready photos.

Finally, get our guide on taking effective medical photos in less than 5 minutes:

Image courtesy of auggie_tolosa on flickr.com, used under Creative Commons rights.

Increasingly, taking photos is a part of our lives. We snap photos when we're out at dinner or on a trip. And we certainly want to take a picture when we see an interesting case or need to remember or share something about a patient.

With the significant fines and punishments for HIPAA violations, however, medical photography on your iphone or smartphone brings up a several HIPAA compliance and security issues:

• If your phone gets lost, all photos on your camera roll are insecure
• Once a photo is on your phone, it is tempting to email or text it, both of which are in conflict with HIPAA.
• Photos on your camera roll may be susceptible to access by apps that are not HIPAA compliant.

So what is a person to do? It seems ridiculous to choose not to use technology in service of patient care. Here is the good news: you can and should use your iPhone or other smartphone for medical photography. In fact, we think that medical photography is a simple, powerful way to improve how we care for patients and make our lives as providers a little easier.

So here is a checklist to make sure that your medical photos are secure and useful:

• Understand HIPAA. You don't need to drive yourself crazy, but a little understanding of the fines and penalties goes a long way 
• Never put patient photos into your regular camera roll. Sometimes smartphone apps (with the exception of iClickCare) pull from your camera roll-- even sharing pictures without your knowledge. And even if that doesn't happen, your camera roll only has one layer of security -- the login password on your smartphone. So when dealing with patient photos, we recommend using a secure app like iClickCare that doesn't ever save photos to your camera roll. You'll know your pictures are safe, and used only for your purposes. 
• Use some overall security strategies so you don't have to worry. When your technology is more secure overall, your photos are more secure, too. 
• Don't email photos. Email is never a secure way to collaborate. 
• Use apps that are explicitly HIPAA-secure. When you do collaborate, only use collaboration platforms that explicitly promise HIPAA security.

Security issues aside, we all want our medical photos to be a little bit better. Get the first chapter of our book on iphone photography for free:

This is the ninth week of our chapter-by-chapter release of Medical iPhone Photography.

Many of you have loyally downloaded each chapter as it has become available.

You have learned:

• Tips and Tricks and the technical reasons behind them.
• Good principles of clinical photography also known as medical photography.
• Some subtle aspects of the iPhone as it is used to take care of patients.

The book is now about to be published in iBooks in the Apple iTunes store, in Amazon, and in Barnes and Noble’s eBook section. Of course, this is complex, and while we delayed this post until everything was tied up with a bow for the holidays, we aren’t quite there yet.

One pleasure of ClickCare is working with wonderful people. For example, the world expert on electronic publishing, Liz Castro, has graciously and expertly helped us finalize our electronic version of the complete book. So stay tuned for our release announcement of the complete Medical iPhone Photography book. We will tweet it as well.

The print version also has been proofed and is ready. It is just the right size (iPhone size) to fit in your pocket and be a holiday gift.

So what is coming in Chapter 9?  We will talk about iClickCare itself, and how it incorporates the excellent medical photographs you have learned to take, and how it allows them to be quickly and conveniently used for discussion and collaboration. HIPAA and HITECH security are both baked in, and managing the network is familiar and easy. If you have an organizational administrator setting things up, fine, and if not, you can do it yourself.

Look for the printed version as well as the electronic forms. We are aiming to make your holiday shopping easier just now, and the rest of the year stress free as well.

In the meantime download Chapter 9 now, and see the finished picture.

• How to get clear photographs,.

• How to zoom and use macro.

• Pardon me, but what about gloves?
  

Tricks for iPhone camera handling are discussed. It is also remembered that a blurry photograph is frustrating to see (unless it's a background) but it can be better than nothing. Whether you're a physician, a nurse practitioner, a therapist, an aide, or a specialist or anyone else who cares, this is just part of good communication.

While you are taking Thanksgiving pictures, REMEMBER TO HOLD THE CAMERA STILL. Clear photographs will even make Thanksgiving happier!

In Chapter 5, the control of focus and of lighting is discussed. 

Downlooad to learn how to use the iPhone for good and for evil.

In this blog post, 

• How to make an aged face look younger.
• How to erase wrinkles without creams, surgery, or exercise.
• How to hide ugly scars.

Images and Words create better communication together than each alone.

Collaboration is all about communicaton. Communication needs to be honest and collaboration requires the respect of each collaborator for one another.

Photography is all about light and how it is collected, used and interpreted.

It is the manipulation of light which like any tool can be used for good (consistency) and evil (misrepresentation).

Search for before and after photos after you download Chapter 5. Observe the before and after photographs and see where flash is used to over expose skin and fill dark areas. You can copy this, and  “erase”  wrinkles. Small changes in focus can also “soften the skin” and thus make skin treatments look better than they are.

DId you know that when HD TV was introduced a few years ago, it created quite a problem for the on-air personalities. Out-of-focus blemishes on the talent had no place to hide.

Want to make scars “disappear” in the same way as wrinkles?  Defocus the camera by choosing Macro and then moving out of its range. Or use the focus square to focus on something just a little off the target plane. The subject becomes blurred against a sharp background. Finally, want to get that “turkey gobbler” neck to go away? Easy, extend the neck forward, move the jaw forward, lift the chin, you can have a pretty good result.

We don’t condone these techniques, but you should be aware of them. As you collaborate with your trusted network, you can judge for yourself and decide who to trust. Figures lie, Liars figure.  Medical photographers can do both.

In Chapter 4, Background & Measurements, you will:

• Recall why measurements matter.

• Decide what to leave in and what to take out.

• Learn simple tricks to choose an optimal background.

  There is no question that collaboration is enhanced by having words and pictures presented as an ensemble, together, rather than separately. Clear communication requires structured writing, and photography is no different. Photographs illustrate deeply and quickly what text struggles to describe. Text gives history and relevance to photographs.

The chapters below, include, among other things:

Chapter 1:

What clinical and medical photography are

What makes a good clinical photograph

Chapter 2: 

Why HIPAA and HITECH compliance is important in medical iPhone photography

Why setting up photographic permissions properly enhances patient care

Chapter3: 

How to use the ePub feature on the iPhone and related tablets

How to pose and frame for maximum communication and comparison

Now the NEW Chapter 4:

Discusses background, color distraction and measurement. It has common sense suggestions born of many years experience. For instance, why is blue an ideal background color?

Download Chapter 4 here. As always we strongly encourage your comments, corrections, and most of all, any sharing (this is medical collaboration, after all) of your own experiences.

Using Chapter 3 of Medical iPhone Photography, we show you how to put an ePUB file on your iPhone and continue learning great camera techniques.

Chapters 1 and 2 reminded us to use the camera "in your pocket" and make sure the pictures are recorded on a secure camera roll. Chapter 3 gets into posing or positioning the patient...so that clinical progress or deterioration can be professionally mapped.

As described in previous blogs, Medical iPhone Photography will be released in 2 formats, the .epub for iBooks, Nooks and all eBooks except for Kindles...and the .pdf for everything else. In order to bring up the .epub file as an iBook, please follow these instructions:

1. Open iTunes and drag the downloaded .epub file over to the Library section of iTunes with BOOKS selected. 

 2. Plug your iPhone or iPad into your computer and let it SYNC automatically.

3. Open your new "book" from your iPad's or iPhone's iBook shelves and enjoy learning.

After you open your iBook, touch the page and to choose print size, white or sepia background, and intensity of the lighting. You can view the book in either portrait or landscape mode. You can place bookmarks or do a search. Also you can highlight passages, you can enlarge pictures, you can ask for word definitions...all while sitting on the couch!

But the most fun of all is TURNING THE PAGES IN AN eBOOK!!! Slide from the right to the left to see the next page; slide in reverse to go back. And this is something that you cannot do with the PDF format! So take these extra steps.

When you have the whole Medical iPhone Photography book, there will be lots more interesting pages to turn.

• What is clinical photography? Is it medical photography?
• What is the best camera for clinical photography.
• What makes a good clinical photograph.

Chapter 1 reminded us about the importance of the obvious: Take the picture. Hold the camera still. And archive the picture for easy retrieval!

In Chapter 2, we will get Permissions, HIPAA and HITECH carefully understood. You might subscribe to our blog so that you don't miss a chapter!

Throughout the course of 9 serial lessons we will show you how to maximize the remarkable capabilities of the iPhone, understand the principles of medical and clincal photography, and feel comfortable with documentation both descriptively and visually.

There is quite a history, but the value of good consistent clinical photographs is without change.

At this point in time, the quality from that small camera "in your pocket" is amazing because the picture is taken instead of missed. When coupled with the techniques in these chapters, the communication is only improved.

Medical iPhone Photography will be released one chapter a week until mid December...as both an iBook for the iPad or iPhone or a PDF for everything else. Then the book will become available in printed form for holiday giving to your favorite healthcare provider.

• What is clinical photography? Is it medical photography?
• What is the best camera for clinical photography.
• What makes a good clinical photograph.

Starting today, we are excited to share decades of experience in medical and clincial photography using digital cameras. The paradigm shift from the time of the first Apple QuickTake is awe inspiring. Still, the value of good consistent clinical photographs is without change.

In 9 lessons we will show you how to maximize the remarkable capabilities of the iPhone, understand the principles of medical and clincal photography, feel comfortable in documentation both descriptively and visually.

It is true that the iPhone camera interface is intuitive, but while the one of the authors was writing the manuscript, the other was learning tips about flash settings and posing the patient while editing. When the tables were turned, the primary author learned new things about the automatic macro and video "righting." Originally the digital photography revolution was seen as a way to take and store before and after pictures easily; originally the resolution and the camera functioning was not ideal. At this point in time, the quality from that small camera "in your pocket" is amazing when coupled with these simple techniques.

Medical iPhone Photography will be released one chapter a week until mid December...as both an iBook for the iPad or iPhone or a PDF for everything else. Then the book will become available in printed form for holiday giving to your favorite healthcare provider.