Legal considerations and recommendations for SAS implementation
| Category | Legal considerations | Recommendations |
| Privacy and confidentiality | Patients, radiologists, and support staff may have privacy and confidentiality concerns. Patients might have reservations about having their procedure filmed. Staff may have additional concerns that videos can be used for employee monitoring and performance rating. | In accordance with principles set out in the Health Insurance Portability and Accountability Act (USA) or Health Records Act (Victoria, Australia), video should contain as little identifiable information as necessary to minimize privacy invasion.25 26 Some SAS solutions such as Olympus MedPrescence offers built-in video post-processing to aid de-identification. |
| Litigation | Fear of litigation can inhibit implementation of SAS. | Administrators should be reassured that there is no substantial evidence in the literature that video technologies promote litigation.27 Instead, video records have been successfully used to defend against claims of medical negligence and malpractice.28 29 Nevertheless, for SAS to succeed, video records should be safeguarded against litigation purposes and be limited to education and research purposes only. |
| Ownership and security | Legislations vary on whether video records should constitute medical records. | Local legislation should be considered and appropriate storage and security measures implemented.26 |
| Informed consent | Video records and broadcasting will require appropriate consent procedures. | Informed consent from all relevant stakeholders is essential to ensure legal and ethical use of SAS. |
| Teleproctoring | Legal liability of teleproctoring should be clarified with a hospital in-house legal counsel as legislations can vary. | Conventionally, teleproctors or telementors are considered as educators who do not have any direct doctor–patient relationship and, hence, have legal immunity in cases of malpractice.30 |
SAS, smart angiography suite.