Patient files and clinical photos

Adding a file or photo

Open the patient and press Add or view photos and files (under Files and photos). On a phone or tablet, Take a photo opens the camera; Choose a file picks a PDF or an image from your device or computer. Then say what it is: a title, a type, and the date it was taken or written (today unless you change it), and press Save.

Images are made smaller on your device before they're sent, and anything the camera saved in them, including where the photo was taken, is removed. PDFs are kept as they are, up to 20 MB. JPEG, PNG, WebP and iPhone HEIC photos work (HEIC where the browser can open it, as Safari can; otherwise choose a JPEG, or on the iPhone set Settings → Camera → Formats → Most Compatible).

Clinical photos

A clinical photo needs its site: the left or right foot, then where on it (each toe and each toenail, the ball of the foot, sole and arch, heel, top of the foot, inside or outside edge, between the toes, ankle, Achilles or lower leg). You can add a measurement (length and width in millimetres) and a short note. Your foot and site choices stay filled in for the next photo, so a run of photos from one visit is quick.

Each site gets its own timeline, oldest first, so you can see a wound, verruca or nail change over a course of treatment. A finding on a foot chart or a wound measurement can link to a photo of its site (see Foot charts and Wound measurements).

Comparing two dates

On any site with two or more photos, press Compare two dates. The two photos sit side by side, the earlier one on the left, even on a phone: the first and the latest to start with. Tap a date under either photo to change it. If both photos were measured you'll see how much smaller or larger it is (by area, or by length when there's no width), and how long between them.

From a clinical note

While you're writing a note, Photos at the bottom adds photos straight from the note; they also go on the record, in the timeline for their site. Once the note is signed its photos are locked with it; to add more, amend the note. Discarding a draft keeps its photos on the record.

Who sees what

Documents (letters, scans, reports) are for anyone who can open the patient's record, reception included, so they can file referral letters. Clinical photos are for clinicians and the owner only. Practitioners see the files of patients they've seen, as with the rest of the record. Whoever added a file, or the owner, can change its details or remove it; a photo on a signed note only the owner can change.

Types

The types offered (Referral letter, Scan or X-ray, Wound, Verruca, Nail and so on) are yours to change in Settings → Categories → File types.

Privacy

Files are kept in private storage and opened only through links that last a few minutes, given to people signed in at your clinic who may see them. Titles, notes and measurements are encrypted with your clinic's own key. Every view, download, upload, change and removal is recorded in the audit log. In private mode photos and previews aren't shown at all (or even loaded), and titles and notes are hidden. Removing a file deletes it for good; so does erasing a patient's records after the retention review (Settings → Account) and closing the clinic. A subject access export lists every file with its details.