BIOS have developed processes to enable the offering of live patient assessments to be streamed directly to universities to support/enhance their clinical studies and they have developed a secure web portal called the Placement Expansion Resource Library, which is designed to support orthoptic students by providing a rich repository of learning resources. We invite clinical tutors from all over the nation to get involved in these both initiatives to help train the next generation of orthoptists.
Below you will find detailed instructions on how to get involved and the tasks you will need to undertake to ensure compliance with data protection regulations.
Review the proposed workflows to help you assess how these processes will fit in with your existing clinic workflows.
Before initiating the approval process (Step 3), please review the following checklist to ensure your clinic setup can be adapted to meet the requirements. This includes reviewing the clinic and technical setup to verify whether current processes can be aligned with the proposed future state workflows detailed in Step 1.
- Pre-appointment Information: Patients should be able to receive relevant process information 1-2 weeks before their appointment, so that an informed decision can be made.
- Patient Posters: Promote the project in patient accessible areas.
- Flexible Clinic Scheduling: Clinic schedules should be adaptable to accommodate extended video appointment times for additional preparations, discussions, filming, and uploading videos. Sufficient time must be allocated to ensure all patient videos are uploaded to a secure network drive and removed from the recording device.
- Consent Forms: It is the departments responsibility to store a copy of the signed patients consent form and make a note the uploaded Video ID at the top of the form. This will help support any future consent withdrawal.
- Quiet and Clean Recording Environment: A quiet, clean space is necessary to avoid capturing unconsented audio, people, or patient information during video capture.
- Reliable Wireless Connectivity: Good wireless connectivity is essential for live streaming via a Hololens. A heat map of the area can be requested from the network team to assess Wi-Fi signal strength. If the signal is weak, explore options with the network team to improve it. If this is not possible, consider offering recorded patient assessments for access via PERL instead of live streaming.
- Promote Regular Appointment for Live Streaming: Send a recurring calendar appointment to all four universities.
Equipment/Software Access:
- iPad/Tablet and Stand: Needed for recording patient videos.
- Hololens: Required for live streaming. Access to a Hololens can be requested from BIOS after receiving approval for live streaming.
- 365 Remote Assist Licence: Required for live streaming via a Hololens on Microsoft Teams. Access to a license can be requested from BIOS after receiving approval for live streaming.
- Trust PC/Laptop Access: Needed for uploading the patient videos from the recording device to the trusts secure network.
- Secure Network Drive Access: A secure network drive is necessary for securely storing patient videos and removing them from the recording device. Access can be requested from the departments local IT team.
- Vimeo: Is a video hosting site like You Tube. BIOS has secured a licence to Vimeo that allows videos to be securely uploaded for private accessibility. All uploaded video resources will be locked down so that they can only be accessed via the secure PERL. Access to a secure Vimeo account can be requested from BIOS after receiving approval for recording patients’ assessments.
- PERL: Accessing patients’ videos will be granted to BIOS Members who can demonstrate they complete mandated annual data security assessments.
A Data Protection Impact Assessment (DPIA) is a process to help the organisation identify and minimise the data protection risks of a project. It is required when processing personal data, particularly sensitive data such as health information.
To share your patient video assessments with BIOS or the universities, it is crucial to complete a DPIA with your local organisation to ensure compliance with data protection laws. Here is how:
1. Download the BIOS Approval Guide for Live Streaming and Recording Patient Videos
Please download this guide from the BIOS website: Approval Guide for the Live Streaming and Recording of Orthoptic Assessments
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- Each organisation has their own unique DPIA approval system. BIOS has worked with several NHS organisations to support their DPIA process. The information learnt from this work has been summarised in the attached approval guide to help guide future organisations.
- Here you will find useful information regarding the original project, potential questions to ask of your local Information Governance/Data Protection team, a risk register, current and future state process maps, and a sample DPIA. If your organisation has any additional questions that are not referenced in this guide, please contact BIOS.
3. Draft a Formal Request to the Data Protection Department:
Prepare a formal request to your local hospital administration or the data protection office, outlining the intent to live stream and record patient assessments for educational purposes. The department may request an initial face to face meeting with you to help them better understand the proposal and to convey their approval process. The key points to discuss with data protection are as follows:
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- Purpose: The aim is to stream live video assessments via Microsoft Teams using a Hololens device. This link will be shared will universities so that the live assessment can be presented during university lectures. In addition, the ask is to also record patient orthoptic assessments for access via a secure portal called the PERL, which is only accessible to BIOS members. This will enable the production of educational material which can be used for supporting continued professional development within the profession but can also be used by participating universities to bridge the gap in providing simulated placement opportunities to support the development of orthoptic students.
- Data Protection: Provide assurance that a Standard Operating Procedure document is available to ensure all video recordings are captured within a specific criterion to minimises the risk of any other patient/clinician information being shared. All patient videos are to be pseudo-anonymised before uploading to the secure BIOS account on Vimeo and the videos will only be made accessible via the secure BIOS portal called the PERL. This portal complies with the same password security criteria as nhs.net and has recently been penetration tested, to ensure maximum protection for our videos. In addition, there are processes in place to ensure users only receive access to the PERL if they have passed the yearly Data Handling assessment.
- Sharing Agreement: The data protection department may prefer to have a sharing agreement in place between their trust and BIOS. Please see below for a proposed sharing agreement and discuss this as an option with your data protection team. If this agreement is accepted, please forward to BIOS for a signature.
Signed Sharing Agreement from BIOS
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- Storage and Access: Review the proposed workflow diagrams which specify how the recordings will be securely stored and who will have access to them.
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- Consent: Provide examples of the proposed patient information leaflets, designed to be shared with patients at least one week before their appointment to ensure they can make an informed decision and provide informed consent. Posters are available for printing and display in patient-accessible areas. A consent withdrawal process is also in place, allowing patients the flexibility to withdraw their consent at any point in the future.
- Risk Review: Ascertain if the Data Protection Department has identified any other data protection and review these against the BIOS Risk Register, available in the approval guide. Outline the measures BIOS has taken to mitigate these risks. If any further risks are identified, please raise these directly with BIOS.
4. Complete the DPIA (Data Protection Information Agreement) Form:
You should now have enough information to complete your DPIA. If there are any questions that you are unsure of, please contact BIOS and we will be happy to help.
5. Submit for Feedback/Approval:
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- Once completed, submit the DPIA to your local hospital’s data protection/information governance officer or relevant authority for review.
- If the department has any further questions which you are unable to answer, please forward these to BIOS so we can feed back a response.
- Obtain written approval before proceeding with any live streaming or recordings.
When you receive a final response from your Data Protection team, they should provide written confirmation of one of the following decisions:
- Decision 1: Approval granted to begin live streaming and recording patient assessments.
- Decision 2: Approval granted to begin live streaming patient assessments.
- Decision 3: Approval granted to begin recording patient assessments.
- Decision 4: No approval granted – consider exploring the option to share anonymised clinical resources.
Decision 1 – Approval for Live Streaming and Recording of Patient Videos
Network Confirmation:
The network team has verified that the designated area for live streaming patient appointments has strong wireless connectivity.
Hololens Setup and IT Approval:
The Hololens2 can be set up with a personal Microsoft account. This provides the security features of biometric (iris), PIN, and password authentication. It also enables BitLocker Device Encryption (BDE) to protect the device from unauthorised access. BIOS recommends setting up a generic account for shared access by multiple users. Once set up, BIOS will need to be notified of the email address used to procure a 365 license.
Alternatively, IT may require that the Hololens be set up on the trust’s Microsoft Azure account. This process could take longer than expected, depending on IT’s capacity to complete the setup. Additionally, BIOS will need to coordinate with IT to arrange funding for the 365 license to enable live streaming via Microsoft Teams.
Hololens Access and Management:
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- Apply for access to a Hololens through BIOS.
- Provide a secure location for storing the Hololens when not in use.
- Sign the hardware disclaimer (Link) and return it to BIOS.
Required Access:
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- Secure Network Drive: Request access from the trust’s local IT team for storing recorded patient videos.
- Vimeo: Request access via BIOS for video hosting and streaming.
Decision 2 – Approval for Live Streaming Only
Network Confirmation:
The network team has confirmed that the designated area for live streaming patient appointments has reliable wireless connectivity (confirmation required from the network team).
Hololens Setup and IT Approval:
The Hololens2 can be set up with a personal Microsoft account. This provides the security features of biometric (iris), PIN, and password authentication. It also enables BitLocker Device Encryption (BDE) to protect the device from unauthorised access. BIOS recommends setting up a generic account for shared access by multiple users. Once set up, BIOS will need to be notified of the email address used to procure a 365 license.
Alternatively, IT may require that the Hololens be set up on the trust’s Microsoft Azure account. This process could take longer than expected, depending on IT’s capacity to complete the setup. Additionally, BIOS will need to coordinate with IT to arrange funding for the 365 license to enable live streaming via Microsoft Teams.
Hololens Access and Management:
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- Apply for access to a Hololens through BIOS.
- Provide a secure storage location for the Hololens when not in use.
- Sign the hardware disclaimer (Link) and return it to BIOS.
Decision 3 – Approval for Recording Patient Videos Only
Secure Network Drive Access:
Request access from the trust’s local IT team to ensure patient videos can be securely stored.
Vimeo Access:
Request access through BIOS for video hosting and sharing.
Equipment Requirements:
Ensure access to an iPad/tablet and a stand for recording patient videos.
Decision 4 – No Approval
Even if you have not received approval for the above decisions, you can still contribute to clinical teaching by sharing valuable resources. Orthoptic departments can help enrich the PERL platform by submitting materials that support clinical education, such as:
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- Hess charts, fields of uniocular fixation, and BSV
- Case notes or case scenarios
- Interesting cases
- Worksheets
Please ensure all resources are fully anonymised before submission. If you have resources to share, email them to the Clinical Placement Expansion Project Team at [email protected].
You can also access sample resources and templates by logging into the PERL. For more details, visit the PERL – Sharing Resources page.
Ready to contribute? Once you have written approval of your Trust’s DPIA, please notify the BIOS team.
You can then start recording patient assessments using a Trust-provided tablet, iPad, or video recording device.
For live streaming patient appointments, request access to a HoloLens2 device and a Remote Assist account from BIOS. For full details, visit the Accessing a HoloLens Device for Your Trust page.
If you need any assistance or further information, contact us at [email protected].