Patients filming their own EMS calls ?!

[ems-buff 81]

In this new day and age everyone, from the 5 year in the baby stroller to grandma and grandpa, have access to a video/camera phone. Most recently we seen this type of raw footage with the Brooklyn firefighter burned yesterday ( god bless and best wishes on a speedy recovery), but when is enough is enough mentality come into play?

Today I saw a Facebook post by the JEMS website that had me thinking why? You have a pt of unknown age being transported to a hospital after being involed in an MVA where he was on his way to school. Yet the EMS crew allowed the pt to flim his own transport . Is that appropriate? Do you think if you were the person in-charge; would you allow it? Being he is your pt, do you think there is some form of HIPPA violation that you, your crew, the company you work for can be held liable for. Are there waivers that you have your pts sign in cases like this. Heres the big question.. If it makes you as the EMS professional uncomfortable can you legally have him stop recording..

I just wanted to hear everyone elses thoughts on this subject. I posted a link below..

JEMS Article

[JohnnyOV 2]

In this new day and age, everyone from the 5 year in the baby stroller to grandma, and grandpa have access to a video/camera phone. Most recently we seen this type of raw footage with the brooklyn firefighter burned alive yesterday ( god bless and best wishes on a speedy recovery), but when is enough is enough mentality come into play?

Today I saw a Facebook post by the JEMS website that had me thinking why? You have a pt of unknow age been transported ti a hospital after being involed in an MVA where he was on his way to school. Yet the EMS crew allowed the pt to flim his own transport . Is that appropriate?, Do you think if you were the person incharge; would you allow it? Being he is your pt, do you think there is some form of HIPPA violation that you, your crew, the company you work for can be held liable for. Are there wavers that you have your pts sign in cases like this. Heres the big question.. If it makes you as the EMS professional uncomfortable can you legally have him stop recording..

I just wanted to hear everyone elses thoughts on this subject. I posted a link below..

JEMS article

I wish some of the patients filmed the local VAC... Walking MVA pts to the car who were involved in major MOIs, never using a KED in the years I've been involved, walking up to scenes with no equipment at all, sitting on a scene when the patient was loaded 10-15 minutes prior into the bus. Might convince them to actually do their job the right way.

As an EMT, I would have no problem with a patient or news crew filming me, why, because you can bet your arse I'll be following protocol. Have always, and will always continue to do that. Your skills should be fined tuned enough that you're completely comfortable operating in front of a camera. If you're going to freeze up and second guess yourself, then maybe you need to find another profession / volunteer area.

edit: also, I doubt it would be a HIPAA violation if the pt is filming, and releases the footage on their own accord. The HCP is not the one releasing the PT's info, the actual PT is.

Edited December 20, 2011 by JohnnyOV

[helicopper 1,050]

In a public place, I may be willing to let it slide but not the back of my ambulance. Not a public place, subject to the rules and regulations of my agency, and if they're filming while immobilized they're going to be screwing up my care. They'll be turning their head to look around, moving their arms, etc. If they're immobilized they should be immobile!

Does anyone have a policy on filming within their ambulance?

[Guest alsfirefighter]

If its the patient I don't know what you could do other then to politely ask them not to video the event or ask that you would like to not be recorded, however your voice will still be on the recording. I agree with helicopper that once in an ambulance you can request that it stop. I would use what I generally do when pics/videos are being taken by friends or the occasional patient that it is interfering with the flow of my patient care and that their health/well being is the most important to me. We have a gentleman that loves to record MVA's and calls that are occurring outside to post on a local web media site. I have several times asked him to stop and of course he pulls the I'm on public property but I explain to him that him recording can and does cause a distraction. I've been in the presence of several LEO's when on calls who also tell those recording the same thing. It simply adds another element that is not needed.

[JohnnyOV 2]

We have a gentleman that loves to record MVA's and calls that are occurring outside to post on a local web media site. I have several times asked him to stop and of course he pulls the I'm on public property but I explain to him that him recording can and does cause a distraction. I've been in the presence of several LEO's when on calls who also tell those recording the same thing. It simply adds another element that is not needed.

I refer you to the 1st amendment... and statter911.

http://statter911.com/2011/12/18/what-gives-no-outrage-over-ghoulish-photographers-shooting-bodies-has-something-changed-in-year-since-connecticut-trooper-blasted-cameraman/

As much as I disagree with the the filming of accidents, patients, and the operations, the constitution allows for the freedom of the press to film and report what they want that is open to pubic viewing. Morally and ethically is it OK, probably not. There has been incidents of firefighters and EMS workers getting fired over the release of medical photos and videos, but again, we're held accountable under HIPAA.

The only thing that can effectively keep the news out of a certain area, is to set up a secure zone and consider it a crime scene or active investigation site, thus prohibiting the reporters from entering the restricted area. Other then that, it is fair game.

[nycmedic 65]

I know a a vac that has a video and audio recorder that records the patient compartment and the road. If your company can do it what is stopping civilians from doing so.

[PFDRes47cue 653]

I know a a vac that has a video and audio recorder that records the patient compartment and the road. If your company can do it what is stopping civilians from doing so.

Do you feel the same way about dash cameras in police vehicles?

[SRS131EMTFF 471]

I know a a vac that has a video and audio recorder that records the patient compartment and the road. If your company can do it what is stopping civilians from doing so.

Well whoever they are is committing a HIPAA violation from what I am told. I asked two different services in two different states I was with if it was possible to add that feature to our ambulance spec. and I was told both times that it was a violation and not allowed.

I have been filmed and photo graphed many times while on scene and I do not feel that it affects my performance. It is just one more thing to ignore when treating a patient or conducting operations. I focus on my job, not on the distractions. While I have never had someone try to photograph or film their treatment in the back of the ambulance, so long as it does not interfere with my treatment and assessment, I have no problem with it. However, once it gets in my way, it will go away for good.

I watched a video where a man had a parachute malfunction at 2,500ft, had a hard landing and was paralyzed from the arms down. During his entire fall and treatment in the ambulance his iPhone was recording. While the video of the treatment by first response and emergency services is not available, it should bring to light that this might be happening without you even knowing it. I know a lot of skiers will have a camera strapped, bolted or otherwise attached to the gear in someway.

[SRS131EMTFF 471]

You were told wrong. The ambulance service cannot videotape the encounter, but the patient can. Again, they waive HIPPA protections by releasing the tape to any third party.

I was asking about us videotaping them. Thus the violation.

[helicopper 1,050]

I know a a vac that has a video and audio recorder that records the patient compartment and the road. If your company can do it what is stopping civilians from doing so.

Is this one of the "crash" camera systems? Is it adjusted to record facing the stretcher or just the back of the stretcher looking toward the doors?

You can of course stop civilians from doing something on or in your property that you can do yourself. That's the difference between public and private property.

Does this VAC have a policy on recording or using this camera system?

[helicopper 1,050]

For all who are saying "HIPAA violation"... What is the "individually identifiable health information" that is contained in an image? Nowhere does it state that a patient's likeness, image, or photograph is protected information.

Why all the hub-bub about HIPAA or am I missing something?

What Information is Protected

Protected Health Information. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)."¹²

"Individually identifiable health information" is information, including demographic data, that relates to:

• the individual's past, present or future physical or mental health or condition,
• the provision of health care to the individual, or
• the past, present, or future payment for the provision of health care to the individual,

and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.¹³ Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).

The Privacy Rule excludes from protected health information employment records that a covered entity maintains in its capacity as an employer and education and certain other records subject to, or defined in, the Family Educational Rights and Privacy Act, 20 U.S.C. §1232g.

De-Identified Health Information. There are no restrictions on the use or disclosure of de-identified health information.¹⁴ De-identified health information neither identifies nor provides a reasonable basis to identify an individual. There are two ways to de-identify information; either: (1) a formal determination by a qualified statistician; or (2) the removal of specified identifiers of the individual and of the individual's relatives, household members, and employers is required, and is adequate only if the covered entity has no actual knowledge that the remaining information could be used to identify the individual.¹⁵

Link to Source at HHS website

[nycmedic 65]

Is this one of the "crash" camera systems? Is it adjusted to record facing the stretcher or just the back of the stretcher looking toward the doors?

You can of course stop civilians from doing something on or in your property that you can do yourself. That's the difference between public and private property.

Does this VAC have a policy on recording or using this camera system?

Yes it is. However if the pt is supine they will clearly be visible to the camera. I do not know their policy on the devices because I am not a member of the vac.

[Bnechis 3,961]

Well whoever they are is committing a HIPAA violation from what I am told. I asked two different services in two different states I was with if it was possible to add that feature to our ambulance spec. and I was told both times that it was a violation and not allowed.

HIPAA regulates what info is transfered to whom & how. Filming in and of itself would not be a violation. What you do with it after the fact is up for debate.

Since crews have been accused of stealing, abuse and improper sexual conduct, I would think it might be useful to protect both the crew from being accused and the patient from being a victim.

The key is how its used and if it is saved.

[SECTMB 612]

Ahhhhh, to be a retired Firefighter/EMT remembering how nice it was years ago before it all got ruined by unnecessary regulations and politics both inside and outside the departments and agencies. You know, when you just showed up, did your job, helped the community and went home.

I'm surprised the trial lawyers association isn't giving out free camera phones for Christmas. Nothing makes a slip and fall case better than out of context video.

With all due respect to those who feel their actions are "ready for my close up Mr. Demille", the wrong angle at the wrong time can make you look awfully foolish or worse, incompetent.

It will be interesting to see if there is a spike in settlements for 'nuisance' claims against EMS department as a result of the proliferation of self filming by the patient, family, friend of bystander. Even if you did nothing wrong, there may be questionable action subject to interpretation on film leading to a lot of minimum dollar settlements. Win/Win for the lawyers and patients, big loss for EMS.

[Guest alsfirefighter]

For all who are saying "HIPAA violation"... What is the "individually identifiable health information" that is contained in an image? Nowhere does it state that a patient's likeness, image, or photograph is protected information.

Why all the hub-bub about HIPAA or am I missing something?

Link to Source at HHS website

Thank you!!! Some what 12 or so years later and there are those that still throw out HiPAA as if it is all encompassing. HiPAA was enacted to protect the electronic transfer of private health information. I hear far too many people throw out "its a HiPAA violation" and they don't know the first thing about what it actually is. If that video does have the patient in it and it is secure with limited acesss and not used anywhere else..how in the hell is it a HiPAA violation? Much like the cameras in a police vehicle, they have one that is front facing and often one that covers the back seat..hence if a patient makes a claim that a provider made an inappropriate contact...as Warner Wolf would say.."lets go to the video tape.

[Guest alsfirefighter]

I refer you to the 1st amendment... and statter911.

http://statter911.com/2011/12/18/what-gives-no-outrage-over-ghoulish-photographers-shooting-bodies-has-something-changed-in-year-since-connecticut-trooper-blasted-cameraman/

As much as I disagree with the the filming of accidents, patients, and the operations, the constitution allows for the freedom of the press to film and report what they want that is open to pubic viewing. Morally and ethically is it OK, probably not. There has been incidents of firefighters and EMS workers getting fired over the release of medical photos and videos, but again, we're held accountable under HIPAA.

The only thing that can effectively keep the news out of a certain area, is to set up a secure zone and consider it a crime scene or active investigation site, thus prohibiting the reporters from entering the restricted area. Other then that, it is fair game.

First amendment is great...but I also have rights and morals and one of them is to protect the privacy of my patient. So when I ask and he is a dick about it..no problem. He gets to film the backs of the providers or the officers who block his view no matter where he walks. Most patients and bystanders/family/friends comply when explained that it is a distraction. There was talk from a few states about trying to make it a violation for filming LEO's in the process of their job once they ask to please stop or to go to an area that isn't an interference or distraction. This was on the news after officers in a video arrested a woman who they asked several times to back up and to stop video taping the arrest of an individual who was resisting arrest and when she failed to comply and continuously got close to them making the arrest locked her up..for disorderly conduct and to be honest she deserved it. It clearly showed the distraction as the officers involved had to constantly look up at her circling to ensure she wasn't a threat. Safety comes first...and as a vet who takes constitutional rights seriously as I swore to defend them...there are rights and then there are privileges...or perhaps I should video tape them sitting in their yards..or through there windows while they are doing personal things. I mean its my right isn't it?

[MoFire390 118]

Not for nothing but if the patient wants to video his care and not allow me to do my job as an EMT to help him. Then I believe I have the right to ask him to turn off his/her phone. and you can be sure I will be documenting the incident in my PCR.

There have been many times where i've had patient's family members ask me over the phone what's going on. I explain to them that if they would like to speak with me they can do so at the hospital. patient privicy is one thing that i respect. regardless if they are family of not. I have a pt that i pick up on a daily basis everytime we leave her room she puts the blanket over her own head. So I asked her one day why she does it. and her statement to me was she hated when peope looked at her on the strecher. and that it made her feel uncomfortable.