Smartphone photos may be misleading doctors and putting patients at risk, finds new research

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By Rebecca Payne and Zengbo Wang

Remote triage and consultation is now embedded within general practice. Consequently, patient-submitted smartphone photographs have become routine tools for clinical assessment.

However, the image quality you're reviewing may be fundamentally compromised. There may be pixelation or automatic colour adjustment. The phone may have erased a rash or smoothed the skin. The critical question is whether you're evaluating the actual pathology or an ‘enhanced’ version?

New research from our team, published in The Lancet Primary Care, suggests the answer is often the latter. Smartphone cameras and software routinely alter images in ways that can mislead doctors, and in some cases, put patients at risk of misdiagnosis.

Remote consultations are now routine in many health systems. No longer an emergency pandemic stopgap, general practice is increasingly offered in a “hybrid” way, with patients receiving care in different ways, some in person, many remotely.

Across Australia, North America and parts of Scandinavia, video appointments are commonplace. In the UK, patients are often asked to upload photos through online platforms. Photos are used to diagnose conditions such as eczema or warts, assess responses to treatment and assess how unwell someone appears, informing decisions about if, and how urgently, they need to be seen in person.