Standardization of Guidelines for Patient Photograph Deidentification.

Importance This work was performed to advance patient care by protecting patient anonymity. Objectives This study aimed to analyze the current practices used in patient facial photograph deidentification and set forth standardized guidelines for improving patient autonomy that are congruent with medical ethics and Health Insurance Portability and Accountability Act. Design The anonymization guidelines of 13 respected journals were reviewed for adequacy in accordance to facial recognition literature. Simple statistics were used to compare the usage of the most common concealment techniques in 8 medical journals which may publish the most facial photographs. Setting Not applicable. Participants Not applicable. Main Outcome Measures Facial photo deidentification guidelines of 13 journals were ascertained. Number and percentage of patient photographs lacking adequate anonymization in 8 journals were determined. Results Facial image anonymization guidelines varied across journals. When anonymization was attempted, 87% of the images were inadequately concealed. The most common technique used was masking the eyes alone with a black box. Conclusions Most journals evaluated lack specific instructions for properly de-identifying facial photographs. The guidelines introduced here stress that both eyebrows and eyes must be concealed to ensure patient privacy. Examples of proper and inadequate photo anonymization techniques are provided. Relevance Improving patient care by ensuring greater patient anonymity.