Photos on a case

Clinical photos never go to your phone’s gallery. You can take them inside a case, from Capture, or by handing the phone to your assistant for a whole operation. A photo that isn’t on a case yet waits in Photos to file, at the top of your Inbox, until you file it, keep it in your Teaching file, or delete it. Nothing leaves Photos to file on its own, and nothing is ever deleted for you.

Inside a case

Open a case and tap Take photo. The photo goes straight to that case. Above the button is a row of types: Pre-op photo, Post-op photo, Pre-op X-ray, Post-op X-ray, Intra-op and Other. One is already chosen for you from the case’s date and start time; tap another if it’s wrong.

Already took the photo with your phone’s own camera? Tap Choose from gallery. The photo keeps the time it was taken, not the time you added it, so before and after stay in the right order. Caselogbook can’t remove it from your gallery, so it reminds you to delete it there.

Opening a case also makes it your current case on this phone for the next 12 hours. Photos you take from Capture or hand-off are then suggested for that case.

From Capture

On Capture, tap Photo. The photo goes to Photos to file, ready to be filed with a suggestion. This is the quickest way to take a photo between cases without opening one.

Handing the phone to your assistant

On Capture, tap Hand to assistant, then Start. The screen becomes a camera and nothing else: your assistant can’t open your cases, see patient names, or reach any other part of the app, and the back button does nothing. The screen shows the case by its procedure and side only, never the patient’s name, and counts the photos saved. On phones that allow it, the screen stays awake; if it can’t, the screen says so.

To take the phone back, tap Done and use your fingerprint or face, or type your backup password. A wrong password keeps the camera on. You then land on Photos to file, where the session is marked Taken by your assistant and suggested as intra-op.

If the app is closed or reloaded while your assistant has it, it opens locked. Unlock, and you’re back on the camera with the count kept. Your phone’s own camera screen is outside Caselogbook’s control, so on Android it’s worth pinning the app (Settings → Security → App pinning).

Photos to file

Photos are grouped by month, then day, then session: photos taken close together (no gap over 20 minutes) for the same case. Each session shows its time range and a suggestion:

One case — for example Total knee replacement (right) · [name] · 09:00 · Post-op. Tap File here, check the type, and tap File N photos. Two taps.
Two cases — when a photo could be the post-op of one case or the pre-op of the next, both are shown and you choose. The app never guesses between two patients.
No suggestion — the day’s cases are listed as one-tap choices.

Pre-op, intra-op and post-op are worked out from the case’s operating times when it has them, or from when you dictated it. You can always pick X-ray or another type in the filing step.

Choose another shows your cases from three days either side, and lets you search by name, MRN or procedure. Select lets you tick single photos, to split a session that covers two patients. Teaching file and Delete work on the whole session or your selection.

A photo still uploading says Backing up — you can file it once it’s saved. If photos have waited more than a week, a card reminds you once a week. Later hides it.

When a photo’s time isn’t known

The app reads the time a photo was taken from the photo itself, on your phone, before it removes the camera details. Screenshots, forwarded images and some gallery copies carry no such time; those wait under Time not known, and the app asks you which case they belong to instead of guessing.

On a computer

Drag photos onto Photos to file in the Inbox, or onto a case’s Photos section. They keep their original time. Files that aren’t photos are skipped and the app says how many. Drop the photos, not their folder.

Teaching file

For an interesting photo that isn’t tied to a logged case, such as an outpatient X-ray, choose Teaching file in Photos to file. Pick Photo or X-ray, the body region, add a note if you like, and record consent. The region and note are scrambled on your phone like patient names. Find it under Cases → Photos, in its own section; Open shows the whole list. From there you can edit the details, change the consent, move a photo back to Photos to file, or delete it.

Moving a photo

Open a photo on a case and tap Edit. Change type re-files it on the same case. Move to Photos to file takes it off the case so you can file it elsewhere.

All your photos: Cases → Photos

Beside the case count on Cases, switch List | Photos. On a computer they are two small icons; hold the pointer over one to see its name. Photos shows every photo on every case, newest cases first, each case under a slim header: the date, the procedure and the patient’s name. Inside a case, photos run in the order they were taken. A case shows up to nine photos; +3 more opens the rest.

Three filters narrow it down: Procedure, Region and Date (the last 30 days, the last 12 months, this year, or a range you choose). On a phone they sit under Filter, which shows how many are set, for example Filter · 2. The numbers beside each choice count all your photos, so a choice never disappears while you use it. Photos | Cases switches to one tile per case, showing its post-op photo when it has one. Albums, Show similar cases and Select sit on the same lines, so your photos start near the top of the screen.

The region comes from the case: first the site you recorded (for example “distal radius”), then the procedure (a Fracture distal radius fixation is the wrist), then words in the procedure’s name. A photo whose case says none of these sits under Region not known, which is always there as its own choice. Nothing looks at the picture to decide.

Your Teaching file has its own section at the top, never mixed into your cases. A procedure filter hides it, because Teaching file photos have no procedure.

Names, regions and filters are all worked out on your phone. Photos you have seen before load straight from your phone; the rest download as you scroll.

The slideshow

Tap any photo to open its case’s slideshow. Swipe, or use the arrow keys on a computer. The whole photo always fits the screen, however wide or tall it is. Edit is at the bottom, beside the caption (and Open case, when you opened the slideshow from Cases → Photos); when Edit is open the photo shrinks to stay in view above it. The top shows where you are, for example 3 / 6. After the last photo comes End of this case’s photos: the slideshow never runs on into another patient’s photos. To see another case, close the slideshow and tap one of its photos. Before | After shows the first pre-op photo with the latest post-op one, one above the other on a phone and side by side on a wider screen. Your phone’s back button or gesture closes the slideshow.

Showing a patient their photos

In a case’s slideshow, tap Show patient, then Start. The phone now shows only that case’s photos. Your patient can swipe through them and see Before | After, but can’t close the slideshow, open anything else, or go back. The screen stays awake on phones that allow it; if it can’t, a line says so.

To take the phone back, tap Done and use your fingerprint or face, or your backup password. You return to where you were, with the same filters. If the app is closed or reloaded meanwhile, it opens locked, and unlocking brings you to the case page with Show-patient mode ended.

The power button and your phone’s home gesture still work: they leave the app, but never unlock anything inside it, and opening the app again in a new tab asks you to unlock. On Android it’s worth pinning the app screen (Settings → Security → App pinning), as for hand-off.

Preparing photos for showing

Before a photo can be shown to anyone other than its own patient, two things must be true: the case has Media consent that covers showing to others (a recorded consent, or your standing declaration), and you have cleared it for showing.

Tap Prepare for showing on a case page, in a photo’s Edit sheet, on the Teaching file, on an Album, or — with a filter on in Cases → Photos — on the photos you’ve filtered. Your phone looks at each photo itself and suggests solid bars over eyes and boxes over printed text such as name labels, hospital numbers and dates of birth. The first time, it downloads its detector to your phone (about 18 MB, once). Nothing leaves your phone: no photo, no part of a photo and no result is sent anywhere.

The sheet groups the photos:

Suggested marks — check the bars and boxes; tap a photo to move, resize, add or remove them.
Nothing found — check at a glance — the phone didn’t find anything. That isn’t a pass: look at each photo, then confirm it with No identifiers visible, or confirm them all once every photo has been on your screen.
Not checked by the detector — open each one and check it yourself.
Already cleared — open one to change its marks.

Every photo needs your confirmation; nothing is ever cleared for you. A single letter such as an L or R side marker is left visible and outlined; tap it if you want it covered. If the phone found a face and you confirm without covering it, it asks first. Your marks are saved with the photo, scrambled like the photo itself; the photo you took is never changed. Mark as not cleared stops a photo being shown to others and keeps its marks for next time.

The case page says how many of its photos are cleared, for example 4 of 6 photos cleared for showing.

In a photo’s Edit sheet, tap Share a copy. Your phone makes a copy with the marks burned in and every hidden detail removed (no time, place or camera information), named caselogbook-1.jpg, and shows it to you. Tap Share to send it with your phone’s share sheet, or Download on a computer. Share a copy is offered only for a cleared photo of a case with consent that covers showing to others — even if you mean to send it to the patient themselves, because the app can’t know who receives it. Your patient can always see their own photos in Show patient.

Settings → Photos shared lists what you shared and when. It never records who you shared it with.

Showing similar cases to a new patient

In Cases → Photos, tap Show similar cases. Choose a procedure and up to 20 cases; only cases with consent that covers showing to others, a procedure chosen from the procedure list, and photos cleared for showing are offered. Names are hidden on this screen unless you tap Show names, in case the new patient is beside you.

Tap Start showing, then Start, and hand over the phone. It shows only those cases’ cleared photos, one case after another (Case 2 of 5), each with only the procedure and side, the patient’s age and sex, and how long after surgery the photo was taken. Names, faces, printed labels, dates, hospitals and notes never appear. Nothing else in the app can be reached and the back button does nothing. To take the phone back, tap Done and use your fingerprint or face, or your backup password. You return to your selection.

Albums and teaching

An Album is your own hand-picked set of photos from any cases and your Teaching file. In Cases → Photos, tap Select, tick photos or a whole case, and tap Add to album; you can also add a photo from its Edit sheet or the Teaching file. Give each photo a teaching note if you like. Removing a photo from an Album, or deleting an Album, never deletes the photo.

Play shows the Album on screen for teaching: a title page with the Album’s note, then each photo that is ready to show, with the same details as above and your teaching note — never the case’s own notes or your Teaching file’s private note. Share makes cleared images (up to 20) or one PDF contact sheet with captions, on your phone, and sends it through the share sheet. Photos that aren’t ready are left out, and the sheet says how many and why. There are no web links: nothing is ever kept on our server in a form anyone could open.

Detector credits

Faces are found with YuNet (OpenCV Zoo, MIT licence) and printed text with PaddleOCR’s PP-OCRv4 text detector (Apache-2.0 licence), both running on your phone. Their licence files ship with the app under /models/identifiers/. Both run on ONNX Runtime (MIT licence), the same engine the app already uses for voice.

Once a case has photos, a line appears: Patient consent obtained for clinical photography: clinical use, teaching, and showing to other patients with identifiers removed. Never commercial. Tap it when you have consent. The case then shows the date.

If your surgical consent form already covers clinical photography, you can say so once, under Settings → Photo consent: My patients’ surgical consent covers clinical photography: clinical use, teaching, and showing to other patients with identifiers removed. Never commercial. You choose the date it covers cases from. Cases from that date then show Media consent from your standing declaration, and each still has This patient did not consent for the patient who said no (with Undo). An optional second line, My outpatient consent also covers clinical photography for teaching, extends it to your Teaching file. You can withdraw the declaration at any time. Nothing is ever ticked for you.

Cases consented before this version used older wording that didn’t clearly cover showing other patients. They say so, count for the patient’s own care only, and offer Re-confirm.

Consent is recorded and shown today. Later features that show photos to other patients or for teaching will only use photos whose consent covers it.

What you see while it saves

Each photo always says where it is:

Waiting to upload — saved on this phone, waiting for a connection.
Uploading 40% — on its way.
Upload failed — the app tried a few times. Tap Retry.
Uploading from another device — taken on another phone that hasn’t finished.
Unlock to view — unlock the app to see it.

A photo is only removed from your phone after our server has confirmed it holds a complete copy. If you close the app before that, the photo stays on your phone and the upload carries on next time. If the photos on a case or in Photos to file can’t be shown on this device, the rest of the page still works, and the section says what went wrong and offers Try again. Nothing is deleted when that happens.

Before and after

When a case has a pre-op and a post-op photo, or a pre-op and a post-op X-ray, Before | After shows the first pre-op next to the latest post-op. It’s on the case page above the photos, and at the bottom of the slideshow. With both photos and X-rays, two choices pick which pair. Back to photos returns to the photo you were on.

Deleting

Open a photo, tap Edit, then Delete photo, and confirm with Delete. In Photos to file, use Delete. When you delete a case that has photos, the app asks whether to keep the photos (they go to Photos to file) or delete them too.

Who can see your photos

Only you. Each photo is scrambled on your phone, with a key that only your backup password can unlock, before it leaves the phone. Our server and our storage provider (Amazon Web Services, in Mumbai) hold scrambled files they cannot open. They never get the picture, where it was taken, the camera, the file name, or your Teaching file region and note. The server knows only bookkeeping: which case a photo is on (or that it’s in Photos to file or the Teaching file), when it was taken, whether your assistant took it, and whether consent was recorded. A new phone signed in with your backup password opens all of them; there is nothing extra to back up. Your patient’s name on the Photos view, the body region and the filters are worked out on your phone, never on our server.

The marks you confirm, your Album titles and your teaching notes are scrambled the same way. The server also keeps bookkeeping for sharing: when you cleared a photo, which photos are in which Album and in what order, and that a share happened (when, how many photos, and whether as images or a contact sheet) — never who you shared it with.