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De-identifying POCUS clips

Before uploading any image or clip to EASy POCUS, it must be fully de-identified. This is your responsibility and your institution's policies and applicable law (including HIPAA) apply.

The most common mistake is leaving the patient banner (name, MRN, date) burned into the top of the clip. That text is part of the image — mask it (cover it with an opaque box) or clear it on the machine, not just “deleted” from file properties. Masking keeps the full ultrasound sector and depth scale intact; cropping distorts them.

Acquisition standard — capture every clip the same way

  • 1. Phased-array (cardiac / sector) transducer
  • 2. Adult Cardiac preset
  • 3. Increased far gain (time-gain compensation)
  • 4. Depth set to 21 cm — all six views
  • 5. Marker indicator upper right (cardiology convention)
  • 6. Probe's lowest frequency (typically 2 MHz)

Per the EASy MAP protocol. Off-standard clips may be rejected to keep the training set consistent.

Remove all of these

  • Patient name, initials, date of birth, age in a way that could identify
  • Medical record number (MRN), accession/exam number, account number
  • Any dates (study date/time can be identifying — clear or mask the banner)
  • Facility / hospital name and logo, department, operator/sonographer name
  • Faces or distinguishing features in any non-ultrasound frame
  • File names and folder names containing identifiers (rename before upload)

How to do it

  1. 1On the ultrasound machine

    Use the machine's "anonymize", "clear patient", or "new patient" function before recording, so the patient banner is blank. Many systems can export a de-identified clip directly.

  2. 2If the banner is already burned in

    Mask it — overlay an opaque (black) box over the top patient banner and any facility name/logo, then export so the mask is permanently flattened into every frame (a removable overlay layer is not de-identification). Masking covers the identifiers while preserving the full ultrasound sector, depth markers, and image scale (cropping shrinks the frame and distorts the scale). The banner is part of the image pixels — it cannot be removed by editing metadata alone.

  3. 3Strip metadata

    Export to MP4/JPEG/PNG (not DICOM) — DICOM carries extensive patient metadata. But changing the format alone does not guarantee de-identification: MP4/JPEG/PNG files can still hold metadata (creation dates, device info, embedded tags), and identifiers burned into the pixels survive any export. Remove visible identifiers first, then strip the file's metadata (e.g. re-export or use a metadata-removal tool) before upload.

  4. 4Rename the file

    Give the file a neutral name (e.g. case-rv-strain.mp4) — never the patient's name, MRN, or date.

  5. 5Final check

    Play the whole clip full-screen and scan every corner and the first/last frames for any text, banner, or overlay before you upload.

What we check automatically

Two checks run on every upload, as a safety net for an honest mistake — not as a substitute for the steps above.

  • File metadata is stripped in your browser before the file is uploaded — EXIF and XMP blocks, comments, timestamps and container tags in MP4/MOV, JPEG and PNG. Your filename is replaced with a neutral one.
  • Sampled frames are screened for burned-in text that looks like an identifier — a banner, a name, an MRN, a date. If something is found, the upload is held for a reviewer. It is never deleted and never auto-rejected; a false alarm costs you nothing.

The screen samples a few frames rather than every frame, and it reads printed text rather than everything an image can reveal. It will miss things. Mask the banner.

Before you upload — confirm

  • No patient banner / name / MRN / date visible in any frame
  • Any mask permanently flattened into every frame
  • Exported as MP4/JPEG/PNG (not DICOM) with file metadata stripped
  • File renamed with no identifiers
  • Watched the full clip and checked every corner

If you are unsure whether a clip is fully de-identified, do not upload it.