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206 HIGHSMITH ET AL.

CONCLUSION Hausdorff JM, Mirelman A. Feasibility and
Although dedicated high-resolution cameras effects of home-based smartphone-delivered
would be ideal for biopsy site photography, many automated feedback training for gait in people
referring physicians do not send pictures with their with Parkinson’s disease: a pilot randomized con-
consultations. Some physicians may not integrate trolled trial. Parkinsonism Relat Disord. 2016;
photography into their practice, and others simply 22:28-34.
have the printed photographs on a paper chart and 3. Foltynski P, Ladyzynski P, Wojcicki JM. A new
have not converted to electronic medical record sys- smartphone-based method for wound area mea-
tems (EMRs). Whether the referring and consulting surement. Artif Organs. 2014;38(4):346-52.
physician has adopted EMRs or not, another obstacle 4. Ke M, Moul D, Camouse M, Avram M, Carranza
is that EMRs are not universal and do not link or D, Soriano T, Lask G. Where is it? The utility
synchronize data. Even if all EMRs were fully inte- of biopsy-site photography. Dermatol Surg.
grated, there would still be a potential to violate the 2010;36(2):198-202.
Health Insurance Portability and Accountability Act 5. The Joint Commission Universal Protocol
(HIPAA) if the photos were released. Therefore, the [poster]. [accessed 2016 Mar 2]. http://www.
only truly universal form of photography that would jointcommission.org/assets/1/18/up_poster1.
not violate HIPAA and could go to every patient pdf.
visit would come from the patient’s own smartphone 6. Perlis CS, Campbell RM, Perlis RH, Malik M,
device. Smartphones may one day provide a real-time, Dufresne RG Jr. Incidence of and risk factors
universal, and fully integrated EMR platform between for medical malpractice lawsuits among Mohs
clinicians and patients. However, until a more reliable surgeons. Dermatol Surg. 2006;32(1):79-83.
system is in place, BIOPSY 1-2-3 serves as a simple 7. Zhang J, Rosen A, Orenstein L, Van Voorhees
solution to a common problem in dermatologic sur- A, Miller CJ, Sobanko JF, Shin TM, Etzkorn JR.
gery today. Factors associated with biopsy site identification,
postponement of surgery, and patient confidence
ACKNOWLEDGMENTS in a dermatologic surgery practice. J Am Acad
This work was partially funded by the National Dermatol. 2016; Epub ahead of print.
Institutes of Health Scholars in Patient Oriented 8. Nijhawan RI, Lee EH, Nehal KS. Biopsy site
Research (SPOR) grant (1K30RR22270). Contents of selfies—a quality improvement pilot study to
this manuscript represent the opinions of the authors assist with correct surgical site identification.
and not necessarily those of the U.S. Department of Dermatol Surg. 2015;41(4):499–504.
Defense, U.S. Department of the Army, U.S. Depart- 9. Gurunluoglu R, Kubek E, Arton J, Olsen A,
ment of Veterans Affairs, or any academic or health Bronsert M. No residual basal cell carcinoma
care institution. after excision for biopsy-proven tumor: clinical
and medicolegal implications. Plast Reconstr
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