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Giggin T, Martin KD, Vebugopal SK, Anil KS, Sreeranjini AR, Narayanan MK. Comparative Analysis of Mathematical Models and App-Based Measurement for Estimating the Cutaneous Wound Areas of Captive Asian Elephants. Cureus 2024; 16:e65533. [PMID: 39188424 PMCID: PMC11346670 DOI: 10.7759/cureus.65533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 08/28/2024] Open
Abstract
Objective To evaluate the variation in the area estimation under different mathematical calculations against measurement by a smartphone application in estimating the cutaneous wound areas in captive Asian elephants. Methods The study was conducted on captive Asian elephants (Elephas maximus) with cutaneous wounds reported to Veterinary Hospitals of Kerala Veterinary and Animal Sciences University and elephant camps within and outside Kerala state (mostly southern states of India, namely, Kerala and Tamil Nadu) over the period September 2019 to October 2022. Thirty-five clinical cases diagnosed with skin wounds of different aetiologies at various parts of the body were subjected to measurement, and 111 measurements were taken using a smartphone application, Imito Measure (Imito AG, Zurich, Switzerland). Based on the outer wound perimeters hand-marked on the mobile screen over the image taken, Imito Measure calculated the length, width, perimeter, and area. The length and width measurements from this were applied to four mathematical models of wound measurements. Wound surface area calculations were further done by these models and were compared. Results The observed results indicated no significant difference between the five methods of area measurement in all the studied cases since the P > 0.05. Conclusion The findings revealed no significant difference between the five techniques of wound area measurement. From the practical clinical utility point, the smartphone application has an edge over the mathematical methods in animals, especially captive Asian elephants, as it has the major advantage of being non-contact and thus addresses some major welfare concerns.
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Affiliation(s)
- Thyagaraj Giggin
- Department of Veterinary Surgery and Radiology, Kerala Veterinary and Animal Sciences University, Kerala, IND
| | - Kurisinkal D Martin
- Department of Veterinary Surgery and Radiology, Kerala Veterinary and Animal Sciences University, Kerala, IND
| | - Syam K Vebugopal
- Department of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Kerala, IND
| | - Kundukulam S Anil
- Department of Livestock Production and Management, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Kerala, IND
| | | | - Mulluparambil K Narayanan
- Department of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Kerala, IND
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Choi W, Lim Y, Heo T, Lee S, Kim W, Kim SC, Kim Y, Kim J, Kim H, Kim H, Lee T, Kim C. Characteristics and Effectiveness of Mobile- and Web-Based Tele-Emergency Consultation System between Rural and Urban Hospitals in South Korea: A National-Wide Observation Study. J Clin Med 2023; 12:6252. [PMID: 37834896 PMCID: PMC10573876 DOI: 10.3390/jcm12196252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
(1) Background: The government of South Korea has established a nationwide web- and mobile-based emergency teleconsultation network by designating urban and rural hospitals. The purpose of this study is to analyze the characteristics and effectiveness of the tele-emergency system in South Korea. (2) Methods: Tele-emergency consultation cases from May 2015 to December 2018 were analyzed in the present study. The definition of a tele-emergency in the present study is an emergency consultation between doctors in rural and urban hospitals via a web- and mobile-based remote emergency consultation system (RECS). Consultations through an RECS are grouped into three categories: medical procedure or treatment guidance, image interpretation, and transportation requests. The present study analyzed the characteristics of the tele-emergency system and the reduction in unnecessary transportation (RUT). (3) Results: A total of 2604 cases were analyzed in the present study from 2985 tele-emergency consultation cases. A total of 381 cases were excluded for missing data. Consultations for image interpretation were the most common in trauma cases (71.3%), while transfer requests were the most common in non-trauma cases (50.3%). Trauma patients were more frequently admitted to rural hospitals or discharged and followed up with at rural hospitals (20.3% vs. 40.5%) after consultations. In terms of disease severity, non-severe cases were statistically higher in trauma cases (80.6% vs. 59.4%; p < 0.001). The RUT was statistically highly associated with trauma cases (60.8% vs. 42.8%; p < 0.001). In an analysis that categorized cases by region, a statistically higher proportion of transportation was used in island regions (69.9% vs. 49.5%; p < 0.003). More RUT was associated with non-island regions (30.1% vs. 50.5%; p = 0.001). (4) Conclusions: The tele-emergency system had a great role in reducing unnecessary patient transportation in non-severe trauma cases and non-island rural area emergency cases. Further research is needed for a cost/benefit analysis and clinical outcomes.
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Affiliation(s)
- WooSung Choi
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
| | - YongSu Lim
- Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon 21565, Republic of Korea;
- Department of Emergency Medicine, Gachon University College of Medicine, Incheon 21565, Republic of Korea
| | - Tag Heo
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - SungMin Lee
- Department of Emergency Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; (T.H.); (S.L.)
| | - Won Kim
- Department of Emergency Medicine, Cheju Halla General Hospital, Jeju 63127, Republic of Korea;
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju 28644, Republic of Korea;
| | - YeonWoo Kim
- Department of Emergency Medicine, Andong Medical Center, Andong 36743, Republic of Korea;
| | - JaeHyuk Kim
- Department of Emergency Medicine, Mokpo Hangook Hospital, Mokpo 58643, Republic of Korea;
| | - Hyun Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Republic of Korea;
| | - HyungIl Kim
- Department of Emergency Medicine, Dankook University College of Medicine, Cheonan 31116, Republic of Korea;
| | - TaeHun Lee
- Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Chol Kim
- Department of Emergency Medicine, Saint Carollo General Hospital, Suncheon 57931, Republic of Korea;
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Biagioni RB, Carvalho BV, Manzioni R, Matielo MF, Brochado Neto FC, Sacilotto R. Smartphone application for wound area measurement in clinical practice. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2021; 7:258-261. [PMID: 33997567 PMCID: PMC8095078 DOI: 10.1016/j.jvscit.2021.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/13/2021] [Indexed: 11/03/2022]
Abstract
A total of 85 consecutive patients had their wound area measured. The procedure was executed in two parts. The first was to take photographs of the wound using a smartphone and measure the area using the imitoMeasure application (imito; imito AG, Zurich, Switzerland) by two raters. The second was to take photographs of the same wound using a 10-megapixel digital camera and posterior measurement of the area using ImageJ software (National Institutes of Health, Bethesda, Md) by one operator. The mean area of the wounds was 12.20 ± 10.45 cm2 for imito and 12.67 ± 10.86 cm2 for ImageJ measurement. The interclass correlation coefficient (ICC) between ImageJ and imito was 0.978 for a single measure and 0.989 for the average measure. Considering the two measurements, the ICC demonstrated excellent interobserver correlation using imito (0.987). Larger wounds had a greater difference between the methods (4.28% greater with the ImageJ measurement when considering areas >9 cm2). No difference was found between iOS (ICC, 0.995) and android (ICC, 0.970) smartphone operating systems. The smartphone application is a useful method for area measurement with excellent accuracy compared with digital photography and the ImageJ processing tool.
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Affiliation(s)
- Rodrigo Bruno Biagioni
- Division of Vascular Surgery, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
| | | | - Renato Manzioni
- Division of Vascular Surgery, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
| | | | | | - Roberto Sacilotto
- Division of Vascular Surgery, Hospital do Servidor Público Estadual, São Paulo, SP, Brazil
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Raveendran S, Thomas BP, Jayaseelan V. The Efficiency of WhatsApp in Teleconsultation of Finger Vascularity in Hand Surgery. J Hand Microsurg 2020; 12:163-167. [PMID: 33408441 PMCID: PMC7773502 DOI: 10.1055/s-0039-1683458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background Teleconsultation over the smartphone is now widely used in modern medicine in the management of burns, flap cover, upper extremity trauma, and in the assessment of the feasibility of reimplantation in amputated fingers. The development of the WhatsApp application has enhanced the smartphone's efficiency remarkably to transmit images in clinical and academic settings with its failsafe and encrypted technology. In hand surgery, a teleconsultation technology must communicate details of finger vascularity effectively. However, there is a paucity of evidence on the functionality of these modern teleconsultation technologies in Hand Surgery. Here, the authors have estimated the efficiency of the WhatsApp teleconsultation in the assessment of finger vascularity. Materials and Methods In two phases, the authors transmitted clinical photographs of vascular and avascular fingers to experienced hand surgeons over the WhatsApp and asked them to assess the finger vascularity. The efficiency of the WhatsApp teleconsultation in assessing the details of finger vascularity was estimated from their responses. Results Despite 81.06% of the hand surgeons rating the vascular fingers on the transmitted photographs correctly, only 44.95% detected the avascular digits accurately; that is, 55.05% of the surgeons failed to diagnose the avascularity of fingers. This suggests serious implications in a clinical setting. The intra- and the inter-rater reliability values were 0.232 and 0.6086 (with 95% confidence interval), respectively, which indicated poor reliability of the WhatsApp teleconsultation regarding the assessment of finger vascularity. Conclusion The authors, therefore, conclude that WhatsApp is inadequate in teleconsultation given the value of vascularity details of the fingers in making a diagnosis in hand surgery.
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Affiliation(s)
- Sreekanth Raveendran
- Dr. Paul Brand Centre for Hand Surgery, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Binu Prathap Thomas
- Dr. Paul Brand Centre for Hand Surgery, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Visalakshi Jayaseelan
- Department of Biostatistics, Christian Medical College Vellore, Vellore, Tamil Nadu, India
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Alameddine M, Tamim H, Hadid D, Cheaito MA, Makki M, Maatouk H, Hitti E. Patient Attitudes Toward Mobile Device Use by Health Care Providers in the Emergency Department: Cross-Sectional Survey. JMIR Mhealth Uhealth 2020; 8:e16917. [PMID: 32229474 PMCID: PMC7157496 DOI: 10.2196/16917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/04/2019] [Accepted: 02/06/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Health care provider usage of mobile devices is increasing globally; however, there is little understanding of patient perceptions on this behavior in a health care setting. OBJECTIVE The aim of this study was to assess patients' attitudes toward mobile device usage by health care providers in the emergency department and to identify predictors of these attitudes. METHODS The study was carried out at the emergency department of a large academic tertiary care medical center in Lebanon. A cross-sectional survey design was adopted by administering a questionnaire to medically stable adult patients who presented to the emergency department with an emergency severity index of 3, 4, or 5 between January 2017 and March 2018. The questionnaire collected relevant patient demographic information and included questions related to their mobile device usage along with those evaluating attitudes for the use of mobile devices by health care providers with respect to six major domains: role in health care, distraction potential, impact on communication, empathy, privacy, and professionalism. The attitude toward mobile device usage by health care providers in the emergency department was the main outcome variable. A stepwise logistic regression model was used to assess the association between the outcome variable and the demographic and attitude-related independent variables. RESULTS Among the 438 eligible patients, 338 patients responded to the questionnaire for a response rate of 70.0%. Overall, 313/338 (92.6%) respondents agreed that mobile devices improve health care delivery, whereas 132/338 (39.1%) respondents were opposed to their usage by health care providers in the emergency department (95% CI: 34.0-44.4). The majority (240/338, 71.0%) of patients agreed that mobile devices are a source of distraction to health care providers in the workplace. Females (odds ratio [OR]=1.67, 95% CI: 1.00-2.78) as well as all patients (OR=2.54, 95% CI 1.36-4.76) who believed that mobile devices were a source of distraction, reflecting a lack of professionalism (OR=2.77, 95% CI 1.59-4.82) and impacting the provider's ability to relate to the patient (OR=2.93, 95% CI 1.72-4.99), were more likely to agree that mobile devices should not be used in the emergency department. CONCLUSIONS Patients' negative attitude toward mobile device use in the emergency department is largely driven by patient gender (females), patient perception of the distraction potential of the devices, and their negative impact on the health care provider's empathy and professionalism. The findings of this study shed light on the importance of encouraging stakeholders to impose a digital professionalism code of conduct for providers working in acute health care settings.
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Affiliation(s)
- Mohamad Alameddine
- Department of Health Management and Policy, American University of Beirut, Beirut, Lebanon
| | - Hani Tamim
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Dima Hadid
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad-Ali Cheaito
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Maha Makki
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hadi Maatouk
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
| | - Eveline Hitti
- Department of Emergency Medicine, American University of Beirut, Beirut, Lebanon
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De Simone B, Ansaloni L, Sartelli M, Coccolini F, Napoli JA, Catena F. The Video-Consulting Emergency protocol: a proposition from the World Society of Emergency Surgery members for the initial management of non-traumatic acute abdomen. MINERVA CHIR 2019; 74:189-194. [DOI: 10.23736/s0026-4733.18.07963-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Get the Picture: A Pilot Feasibility Study of Telemedical Wound Assessment Using a Mobile Phone in Cardiology Patients. J Cardiovasc Nurs 2018; 32:E9-E15. [PMID: 27811584 DOI: 10.1097/jcn.0000000000000377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Postprocedural complications after elective cardiac interventions include hematomas and infections. Telemedical wound assessment using mobile phones with integrated cameras may improve quality of care and help reduce costs. AIMS We aimed to study the feasibility of telemedical wound assessment using a mobile phone. The primary aim was the number of patients who were able to upload their pictures. Secondary aims were image interpretability, agreement between nurse practitioners, and patient evaluation of the intervention. METHODS This is a prospective study of all consecutive patients who underwent an elective cardiac intervention. Patients were instructed to photograph their wound or puncture site after hospital discharge and upload the pictures to a secure email address 6 days after hospital discharge. Received photos were assessed by 2 nurse practitioners. The intervention was evaluated using a peer-reviewed questionnaire and photo assessment scheme. RESULTS In total, 46 eligible patients were included in the study, with 5 screen failures (eg, clinical stay ≥ 6 days) and 1 patient lost to follow-up. Thirty-three of 40 patients (83%) were able to upload their pictures. Smartphone users were more successful in uploading their pictures compared with feature phone users (93% vs 55%, P < .01). Eighty-eight percent of the clinical pictures were interpretable. The interobserver variability had an agreement between 93% and 97%. CONCLUSIONS Patients are able to take and upload the mobile clinical photos to the secure email address, and the vast majority was interpretable. Smartphone users were more successful than feature phone users in uploading their pictures. The interobserver variability was good.
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Johnson B, Quinlan MM, Marsh JS. Telenursing and Nurse–Patient Communication Within Fertility, Inc. J Holist Nurs 2017; 36:38-53. [DOI: 10.1177/0898010116685468] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this study is to examine patient perceptions of practitioner–patient communication in reproductive endocrinology and infertility (REI) practices. During this study, we uncovered the importance of telenursing for nurse–patient communication during REI treatment. Telenursing, which is defined as the use of wireless technology for out-of-office communication, is the basis for out-of-office communication. We examined participants’ conceptualization of supportive and unsupportive communication, through the lens of biomedicalization theory. After conducting 23 interviews, we conclude that telenursing is integral to providing holistic nursing care during treatment at REI practices. We discuss efficient and effective uses of telenursing and patients’ positive perceptions telenursing and assess telenursing as both an embrace of and form of resistance to biomedicalization within Fertility, Inc. Theoretical and practical implications are offered, including suggestions for increasing patient access to telenursing while protecting REI nurses from burnout.
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Michiels E, Ouellette L, Bush C, VanDePol E, Fleeger T, Jones JS. Camera phones for the follow-up of soft-tissue injuries in adult and pediatric ED patients: a feasibility study. Am J Emerg Med 2016; 35:782-783. [PMID: 28188056 DOI: 10.1016/j.ajem.2016.10.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Erica Michiels
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine; Helen DeVos Children's Hospital, Grand Rapids, MI.
| | - Lindsey Ouellette
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine
| | - Collen Bush
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine
| | - Eric VanDePol
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine
| | - Tiffany Fleeger
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine
| | - Jeffrey S Jones
- Department of Emergency Medicine, Spectrum Health, Grand Rapids, MI; Department of Emergency Medicine, Michigan State University College of Human Medicine
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11
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Plant MA, Novak CB, McCabe SJ, von Schroeder HP. Use of digital images to aid in the decision-making for acute upper extremity trauma referral. J Hand Surg Eur Vol 2016; 41:763-8. [PMID: 26634398 DOI: 10.1177/1753193415620177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/10/2015] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study evaluated the use of digital smartphone images in the decision-making for acute upper extremity trauma referrals. Surgeons (n = 15) were presented with ten upper limb trauma scenarios for consideration of immediate transfer. Based on verbal history and with additional images, participants were asked questions regarding diagnosis, injured tissues, recommended management and diagnostic and treatment confidence. Statistical analyses evaluated confidence level changes and relationships between confidence levels and independent variables. Confidence levels for diagnosis and treatment were increased with the provision of smartphone images, and this was statistically significant. The decision to transfer was changed in 22%. The photographs were more useful for amputation versus non-amputation injuries (diagnosis and treatment) and hand versus forearm injuries (diagnosis), and these differences reached statistical significance. Smartphone digital images were shown to be useful for decision-making in acute upper extremity trauma referrals. This improved communication may have implications for health cost savings and patient burden by minimizing unnecessary acute transfers. LEVEL OF EVIDENCE Diagnostic Level III.
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Affiliation(s)
- M A Plant
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - C B Novak
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - S J McCabe
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - H P von Schroeder
- Toronto Western Hospital Hand Program, Department of Surgery, University of Toronto, Toronto, ON, Canada
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Ye J, Zuo Y, Xie T, Wu M, Ni P, Kang Y, Yu X, Sun X, Huang Y, Lu S. A telemedicine wound care model using 4G with smart phones or smart glasses: A pilot study. Medicine (Baltimore) 2016; 95:e4198. [PMID: 27495023 PMCID: PMC4979777 DOI: 10.1097/md.0000000000004198] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
To assess the feasibility of a wound care model using 4th-generation mobile communication technology standards (4G) with smart phones or smart glasses for wound management.This wound care model is an interactive, real-time platform for implementing telemedicine changing wound dressings, or doing operations. It was set up in March 2015 between Jinhua in Zhejiang province and Shanghai, China, which are 328 km apart. It comprised of a video application (APP), 4G net, smart phones or smart glasses, and a central server.This model service has been used in 30 patients with wounds on their lower extremities for 109 times in 1 month. Following a short learning curve, the service worked well and was deemed to be user-friendly. Two (6.7%) patients had wounds healed, while others still required wound dressing changes after the study finished. Both local surgeons and patients showed good acceptance of this model (100% and 83.33%, respectively).This telemedicine model is feasible and valuable because it provides an opportunity of medical service about wound healing in remote areas where specialists are scarce.
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Affiliation(s)
- Junna Ye
- Institute of Burns, Ruijin Hospital
| | | | - Ting Xie
- Department of Wound Healing, Shanghai Ninth Hospital, School of Medicine,Shanghai Jiao Tong University, Shanghai, China
| | - Minjie Wu
- Department of Wound Healing, Shanghai Ninth Hospital, School of Medicine,Shanghai Jiao Tong University, Shanghai, China
| | - Pengwen Ni
- Department of Wound Healing, Shanghai Ninth Hospital, School of Medicine,Shanghai Jiao Tong University, Shanghai, China
| | | | | | - Xiaofang Sun
- Department of Wound Healing, Shanghai Ninth Hospital, School of Medicine,Shanghai Jiao Tong University, Shanghai, China
| | | | - Shuliang Lu
- Institute of Burns, Ruijin Hospital
- Correspondence: Shuliang Lu, Institute of Burns, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, No.197 Rui Jin 2nd Road, Shanghai 200025, China (e-mail: )
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On-Call Communication in Orthopaedic Trauma: "A Picture Is Worth a Thousand Words"--A Survey of OTA Members. J Orthop Trauma 2015; 29:e194-7. [PMID: 25210834 DOI: 10.1097/bot.0000000000000236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To quantify the effects of varying clinical communication styles (verbal and pictorial) on the ability of orthopaedic trauma surgeons in understanding an injury and formulate an initial management plan. METHODS A Research Electronic Data Capture survey was e-mailed to all OTA members. Respondents quantified (5-point Likert scale) how confident they felt understanding an injury and establishing an initial management plan based on the information provided for 5 common orthopaedic trauma scenarios. Three verbal descriptions were created for each scenario and categorized as limited, moderate, or detailed. The questions were repeated with the addition of a radiographic image and then repeated a third time including a clinical photograph. Statistical evaluation consisted of descriptive statistics and Kruskal-Wallis analyses using STATA (version 12.0). RESULTS Of the 221 respondents, there were a total of 95 who completed the entire survey. Nearly all were currently taking call (92/95 = 96.8%) and the majority were fellowship trained (79/95 = 83.2%). Most practice at a level I trauma center (58/95 = 61.1%) and work with orthopaedic residents (62/95 = 65.3%). There was a significant increase in confidence scores between a limited, moderate, and detailed description in all clinical scenarios for understanding the injury and establishing an initial management plan (P < 0.05). There was a significant difference in confidence scores between all 3 types of evidence presented (verbal, verbal + x-ray, verbal + x-ray + photograph) in both understanding and managing the injury for limited and moderate descriptions (P < 0.001). No differences were seen when adding pictorial information to the detailed verbal description. When comparing confidence scores between a detailed description without images and a limited description that includes radiographs and a photograph, no difference in confidence levels was seen in 7 of the 10 scenarios (P > 0.05). CONCLUSIONS The addition of images in the form of radiographs and/or clinical photographs greatly improves the confidence of orthopaedic trauma surgeons in understanding injuries and establishing initial management plans with limited verbal information (P < 0.001). The inclusion of x-rays and photographs raises the confidence for understanding and management with limited verbal information to the level of a detailed verbal description in most scenarios. Mobile technology allows for easy secure transfer of images that can make up for the lack of available information from limited verbal descriptions because of the knowledge base of communicating providers.
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Rasmussen BSB, Froekjaer J, Joergensen LB, Halekoh U, Yderstraede KB. Validation of a new imaging device for telemedical ulcer monitoring. Skin Res Technol 2015; 21:485-92. [DOI: 10.1111/srt.12218] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2015] [Indexed: 12/01/2022]
Affiliation(s)
- B. S. B. Rasmussen
- Department of Medical Endocrinology; Odense University Hospital, Denmark; Odense Denmark
| | - J. Froekjaer
- Department of Orthopedic Surgery; Odense University Hospital, Denmark; Odense Denmark
| | - L. B. Joergensen
- Department of Medical Endocrinology; Odense University Hospital, Denmark; Odense Denmark
| | - U. Halekoh
- Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - K. B. Yderstraede
- Department of Medical Endocrinology; Odense University Hospital, Denmark; Odense Denmark
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Plant MA, Fish JS. Resident use of the Internet, e-mail, and personal electronics in the care of surgical patients. TEACHING AND LEARNING IN MEDICINE 2015; 27:215-223. [PMID: 25893946 DOI: 10.1080/10401334.2015.1011646] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND The use of smartphones, e-mail, and the Internet has affected virtually all areas of patient care. Current university and hospital policies concerning the use of devices may be incongruent with day-to-day patient care. PURPOSE The goal was to assess the current usage patterns of the Internet, e-mail, and personal electronics for clinical purposes by surgical residents as well as their communication habits and preferences. Also assessed was residents' knowledge regarding the institutional policies surrounding these issues. METHODS Surgical residents (n = 294) at a large teaching institution were surveyed regarding their knowledge of university policies as well as daily use of various communication technologies. Communication preferences were determined using theoretical clinical scenarios. RESULTS Our survey with a response rate of 54.7% (n = 161) revealed that 93.8% of participants indicated daily Internet use for clinical duties. Most respondents (72%) were either completely unaware of the existence of guidelines for its use or aware but had no familiarity with their content. Use of e-mail for clinical duties was common (85%), and 74% of the respondents rated e-mail as "very important" or "extremely important" for patient care. Everyone who responded had a mobile phone with 98.7% being "smartphones," which the majority (82.9%) stated was "very important" or "extremely important" for patient care. Text messaging was the primary communication method for 57.8% of respondents. The traditional paging system was the primary communication method for only 1.3% of respondents and the preferred method for none. CONCLUSIONS Daily use of technology is the norm among residents; however, knowledge of university guidelines was exceedingly low. Residents need better education regarding current guidelines. Current guidelines do not reflect current clinical practice. Hospitals should consider abandoning the traditional paging system and consider facilitating better use of residents' mobile phones.
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Affiliation(s)
- Mathew A Plant
- a Department of Surgery , University of Toronto , Toronto , Ontario , Canada
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Ge K, Wu M, Liu H, Gong J, Zhang Y, Hu Q, Fang M, Tao Y, Cai M, Chen H, Wang J, Xie T, Lu S. Wound Documentation by Using 3G Mobile as Acquisition Terminal. INT J LOW EXTR WOUND 2014; 14:200-3. [PMID: 25256281 DOI: 10.1177/1534734614549925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The increasing numbers of cases of wound disease are now posing a big challenge in China. For more convenience of wound patients, wound management in community health care centers under the supervision of a specialist at general hospitals is an ideal solution. To ensure an accurate diagnosis in community health clinics, it is important that “the same language” for wound description, which may be composed of unified format description, including wound image, must be achieved. We developed a wound information management system that was built up by acquisition terminal, wound description, data bank, and related software. In this system, a 3G mobile phone was applied as acquisition terminal, which could be used to access to the data bank. This documentation system was thought to be an appropriate proposal for community wound care because of its objectivity, uniformity, and facilitation. It also provides possibility for epidemiological study in the future.
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Affiliation(s)
- Kui Ge
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minjie Wu
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Research Center of Wound Repair, Shanghai, China
| | - Hu Liu
- Shanghai Research Center of Wound Repair, Shanghai, China
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiahong Gong
- Shanghai Research Center of Wound Repair, Shanghai, China
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang Hu
- Dahua Hospital, Xuhui District, Shanghai, China
| | - Min Fang
- Tianlin Community Health Care Center, Xuhui District, Shanghai, China
| | - Yanping Tao
- Tianlin Community Health Care Center, Xuhui District, Shanghai, China
| | - Minqiang Cai
- Xinjing Community Health Care Center, Changning District, Shanghai, China
| | - Hua Chen
- Zhoujiaqiao Community Health Care Center, Changning District, Shanghai, China
| | - Jianbo Wang
- Xietu Community Health Care Center, Xuhui District, Shanghai, China
| | - Ting Xie
- Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Research Center of Wound Repair, Shanghai, China
| | - Shuliang Lu
- Shanghai Research Center of Wound Repair, Shanghai, China
- Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abstract
INTRODUCTION The purpose of this study was to investigate the feasibility of patient-centered teleconsultation for various cutaneous wounds by using store-and-forward technology. MATERIALS AND METHODS From July 2011 to November 2011, 53 patients with various wound conditions were enrolled in this study. The patients took their own wound images shortly before face-to-face consultations with a plastic surgeon, and the images were sent via e-mail to another 3 remote plastic surgeons along with brief medical information. All 4 surgeons completed a standard questionnaire individually, which addressed questions regarding the presence of wound conditions (gangrene, necrosis, erythema, and cellulitis/infection), as well as suggested clinical treatment with antibiotics and debridement. The evaluations were compared among the 3 remote surgeons as well as the remote and onsite surgeons. RESULTS The 53 wounds included in our study exhibited different causative mechanisms and locations on the body. The concordances between the remote and onsite surgeons were 92%, 79%, 83%, and 85% regarding the presence of gangrene, necrosis, erythema, and cellulitis/infection, respectively. The agreement rates regarding the treatment suggestion with antibiotic use and debridement between the remote surgeons and the onsite surgeon were both 83%. The remote surgeons reported high specificity, at least 84%, in all parameters of wound descriptions or treatment suggestions. CONCLUSIONS The patient-centered teleconsultation system based on store-and-forward technology is a feasible tool for wound management, and it shows promises in future clinical applications by decreasing clinic visits.
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Hazenberg CEVB, van Netten JJ, van Baal SG, Bus SA. Assessment of signs of foot infection in diabetes patients using photographic foot imaging and infrared thermography. Diabetes Technol Ther 2014; 16:370-7. [PMID: 24690146 DOI: 10.1089/dia.2013.0251] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Patients with diabetic foot disease require frequent screening to prevent complications and may be helped through telemedical home monitoring. Within this context, the goal was to determine the validity and reliability of assessing diabetic foot infection using photographic foot imaging and infrared thermography. SUBJECTS AND METHODS For 38 patients with diabetes who presented with a foot infection or were admitted to the hospital with a foot-related complication, photographs of the plantar foot surface using a photographic imaging device and temperature data from six plantar regions using an infrared thermometer were obtained. A temperature difference between feet of >2.2 °C defined a "hotspot." Two independent observers assessed each foot for presence of foot infection, both live (using the Perfusion-Extent-Depth-Infection-Sensation classification) and from photographs 2 and 4 weeks later (for presence of erythema and ulcers). Agreement in diagnosis between live assessment and (the combination of ) photographic assessment and temperature recordings was calculated. RESULTS Diagnosis of infection from photographs was specific (>85%) but not very sensitive (<60%). Diagnosis based on hotspots present was sensitive (>90%) but not very specific (<25%). Diagnosis based on the combination of photographic and temperature assessments was both sensitive (>60%) and specific (>79%). Intra-observer agreement between photographic assessments was good (Cohen's κ=0.77 and 0.52 for both observers). CONCLUSIONS Diagnosis of foot infection in patients with diabetes seems valid and reliable using photographic imaging in combination with infrared thermography. This supports the intended use of these modalities for the home monitoring of high-risk patients with diabetes to facilitate early diagnosis of signs of foot infection.
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Wang SC, Anderson JA, Jones DV, Evans R. Patient perception of wound photography. Int Wound J 2014; 13:326-30. [PMID: 24872018 DOI: 10.1111/iwj.12293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 03/31/2014] [Accepted: 04/03/2014] [Indexed: 11/27/2022] Open
Abstract
The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult-to-see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress. There was a significant association between patients' ability to see their wound and their subsequent memory of the wound's appearance. This was especially true for patients who had recently begun visiting the wound care clinic. This relationship was not present in patients who had visited the clinic for 3 or more years. Patients reported that the inability to see their wounds resulted in feeling a loss of autonomy. The majority of patients reported that photographing their wounds would help them to track the wound progress (81%) and would afford them more involvement in their own care (58%). This study provides a current representation of wound photography from the patients' perspective and reveals that it can motivate patients to become more involved in the management of their wounds - particularly for patients with difficult-to-see wounds.
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Affiliation(s)
- Sheila C Wang
- Undergraduate Medical Education, University of Toronto, Toronto, Canada
| | - John Ae Anderson
- Department of Psychology, University of Toronto & Rotman Research Institute, Toronto, Canada
| | - Duncan Vb Jones
- Department of Human Biology, University of Toronto, Toronto, Canada
| | - Robyn Evans
- Wound Care Centre, Women's College Hospital, Toronto, Canada
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Reliability and validity of the revised photographic wound assessment tool on digital images taken of various types of chronic wounds. Adv Skin Wound Care 2014; 26:360-73. [PMID: 23860221 DOI: 10.1097/01.asw.0000431329.50869.6f] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The objective of this study was to examine the validity and reliability of the revised Photographic Wound Assessment Tool (revPWAT) on digital images taken of various types of chronic, healing wounds. SETTING This multicenter trial was performed in a variety of settings where chronic wounds are assessed. PARTICIPANTS A total of 206 different photographs taken of 68 individuals with 95 chronic wounds of various etiologies were reviewed in this study. Wound etiologies included people with venous/arterial leg wounds (n = 13), diabetic foot wounds (n = 18), pressure ulcers (n = 32), and wounds of other etiologies (n = 5). MAIN OUTCOME MEASURES An initial wound assessment using the revPWAT was performed at the bedside, and 3 digital photographs were taken-2 within 72 hours when no change had occurred, and a third was taken 3.5 to 6 weeks later. MAIN RESULTS The revPWAT scores derived from photographs assessed by the same rater on different occasions and by different raters showed moderate to excellent intrarater intraclass correlation coefficients (ICCs) (ICC = 0.52-0.93), as well as test-retest (ICC = 0.86-0.90) and interrater (ICC = 0.71) reliability. There was excellent agreement between bedside assessments and assessments using photographs (ICC = 0.89). CONCLUSION The revPWAT is a valid and reliable tool to assess chronic wounds of various etiologies where digital images are viewed.
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Pimmer C, Mateescu M, Zahn C, Genewein U. Smartphones as multimodal communication devices to facilitate clinical knowledge processes: randomized controlled trial. J Med Internet Res 2013; 15:e263. [PMID: 24284080 PMCID: PMC3868983 DOI: 10.2196/jmir.2758] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 09/17/2013] [Accepted: 10/07/2013] [Indexed: 12/04/2022] Open
Abstract
Background Despite the widespread use and advancements of mobile technology that facilitate rich communication modes, there is little evidence demonstrating the value of smartphones for effective interclinician communication and knowledge processes. Objective The objective of this study was to determine the effects of different synchronous smartphone-based modes of communication, such as (1) speech only, (2) speech and images, and (3) speech, images, and image annotation (guided noticing) on the recall and transfer of visually and verbally represented medical knowledge. Methods The experiment was conducted from November 2011 to May 2012 at the University Hospital Basel (Switzerland) with 42 medical students in a master’s program. All participants analyzed a standardized case (a patient with a subcapital fracture of the fifth metacarpal bone) based on a radiological image, photographs of the hand, and textual descriptions, and were asked to consult a remote surgical specialist via a smartphone. Participants were randomly assigned to 3 experimental conditions/groups. In group 1, the specialist provided verbal explanations (speech only). In group 2, the specialist provided verbal explanations and displayed the radiological image and the photographs to the participants (speech and images). In group 3, the specialist provided verbal explanations, displayed the radiological image and the photographs, and annotated the radiological image by drawing structures/angle elements (speech, images, and image annotation). To assess knowledge recall, participants were asked to write brief summaries of the case (verbally represented knowledge) after the consultation and to re-analyze the diagnostic images (visually represented knowledge). To assess knowledge transfer, participants analyzed a similar case without specialist support. Results Data analysis by ANOVA found that participants in groups 2 and 3 (images used) evaluated the support provided by the specialist as significantly more positive than group 1, the speech-only group (group 1: mean 4.08, SD 0.90; group 2: mean 4.73, SD 0.59; group 3: mean 4.93, SD 0.25; F2,39=6.76, P=.003; partial η2=0.26, 1–β=.90). However, significant positive effects on the recall and transfer of visually represented medical knowledge were only observed when the smartphone-based communication involved the combination of speech, images, and image annotation (group 3). There were no significant positive effects on the recall and transfer of visually represented knowledge between group 1 (speech only) and group 2 (speech and images). No significant differences were observed between the groups regarding verbally represented medical knowledge. Conclusions The results show (1) the value of annotation functions for digital and mobile technology for interclinician communication and medical informatics, and (2) the use of guided noticing (the integration of speech, images, and image annotation) leads to significantly improved knowledge gains for visually represented knowledge. This is particularly valuable in situations involving complex visual subject matters, typical in clinical practice.
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Affiliation(s)
- Christoph Pimmer
- Institute for Information Systems, School of Business, University of Applied Sciences and Arts Northwestern Switzerland FHNW, Basel, Switzerland.
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Sikka N, Pirri M, Carlin KN, Strauss R, Rahimi F, Pines J. The Use of Mobile Phone Cameras in Guiding Treatment Decisions for Laceration Care. Telemed J E Health 2012; 18:554-7. [DOI: 10.1089/tmj.2011.0216] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Neal Sikka
- Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, D.C
| | - Michael Pirri
- Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, D.C
| | - Katrina Norbury Carlin
- Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, D.C
| | - Ryan Strauss
- Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, D.C
| | - Faisal Rahimi
- Emergency Medicine, The George Washington University Medical Faculty Associates, Washington, D.C
| | - Jesse Pines
- Health Policy, The George Washington University, Washington, D.C
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Gardiner S, Hartzell TL. Telemedicine and plastic surgery: A review of its applications, limitations and legal pitfalls. J Plast Reconstr Aesthet Surg 2012; 65:e47-53. [DOI: 10.1016/j.bjps.2011.11.048] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 10/11/2011] [Accepted: 11/25/2011] [Indexed: 10/14/2022]
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Barr C, Yao J. The use of smartphones in hand surgery. J Hand Surg Am 2012; 37:168-70. [PMID: 22196296 DOI: 10.1016/j.jhsa.2011.10.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 10/04/2011] [Accepted: 10/17/2011] [Indexed: 02/02/2023]
Affiliation(s)
- Cameron Barr
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94063, USA
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Ferrero A, Garavaglia G, Gehri R, Maenza F, Petri GJ, Fusetti C. Analysis of the inter- and intra-observer agreement in radiographic evaluation of wrist fractures using the multimedia messaging service. Hand (N Y) 2011; 6. [PMID: 23204964 PMCID: PMC3213258 DOI: 10.1007/s11552-011-9362-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Orthopaedic surgeons are often asked to evaluate X-rays of patients admitted to the Accident and Emergency Department with the suspicion of a wrist fracture or, in the case of an evident fracture, to decide the correct treatment. The aim of this study was to evaluate the feasibility of a correct interpretation of the images of injured wrists on the screen of a last generation mobile phone, in order to evaluate if the specialist could make the right diagnosis and choose the correct treatment. METHODS Five orthopaedic and one hand surgeons have evaluate the X-rays of 67 patients who sustained an injury to their wrist. In the case of fracture, they were asked to classify it according to the AO and Mayo classification systems. The evaluation of the images was accomplished through the PACS and using a mobile phone, at a different time. In order to check the inter- and intra-observer reliability, the same pattern was followed after a few months. RESULTS The mobile phone showed basically the same agreement between the observers highlighting the worsening of the inter- and intra-observer reliability with the increment of the variables considered by a classification system. CONCLUSIONS The present paper confirms that a last generation mobile phone can already be used in the clinical practise of orthopaedic surgeons on call who could use it as a useful device in remote or poorly served areas for a rapid and economic consultation LEVEL OF EVIDENCE The level of evidence of this case is economic and decision analysis, level 2.
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Affiliation(s)
- Andrea Ferrero
- Department of Traumatology and Orthopaedics, James Paget University Hospital, Gorleston on Sea, UK
| | - Guido Garavaglia
- Department of Traumatology and Orthopaedics, ORBV, Bellinzona, Switzerland
| | - Roland Gehri
- Department of Traumatology and Orthopaedics, ORBV, Bellinzona, Switzerland
| | - Ferruccio Maenza
- Department of Traumatology and Orthopaedics, ORBV, Bellinzona, Switzerland
| | | | - Cesare Fusetti
- Department of Traumatology and Orthopaedics, Hand Surgery Unit, Bellinzona, Switzerland
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Derenzi B, Borriello G, Jackson J, Kumar VS, Parikh TS, Virk P, Lesh N. Mobile phone tools for field-based health care workers in low-income countries. ACTA ACUST UNITED AC 2011; 78:406-18. [PMID: 21598267 DOI: 10.1002/msj.20256] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
In low-income regions, mobile phone-based tools can improve the scope and efficiency of field health workers. They can also address challenges in monitoring and supervising a large number of geographically distributed health workers. Several tools have been built and deployed in the field, but little comparison has been done to help understand their effectiveness. This is largely because no framework exists in which to analyze the different ways in which the tools help strengthen existing health systems. In this article we highlight 6 key functions that health systems currently perform where mobile tools can provide the most benefit. Using these 6 health system functions, we compare existing applications for community health workers, an important class of field health workers who use these technologies, and discuss common challenges and lessons learned about deploying mobile tools.
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Engel H, Huang JJ, Tsao CK, Lin CY, Chou PY, Brey EM, Henry SL, Cheng MH. Remote real-time monitoring of free flaps via smartphone photography and 3G wireless internet: A prospective study evidencing diagnostic accuracy. Microsurgery 2011; 31:589-95. [DOI: 10.1002/micr.20921] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 04/25/2011] [Indexed: 11/07/2022]
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Telemedicine in a Rural Community Hospital for Remote Wound Care Consultations. J Wound Ostomy Continence Nurs 2011; 38:301-4. [DOI: 10.1097/won.0b013e3182164214] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Farber N, Haik J, Liran A, Weissman O, Winkler E. Third generation cellular multimedia teleconsultations in plastic surgery. J Telemed Telecare 2011; 17:199-202. [PMID: 21508079 DOI: 10.1258/jtt.2010.100604] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We conducted a study to test whether new third generation (3G) mobile phones could be integrated into service as a working tool between plastic surgeons. During an eight-month period, 58 multimedia consultations were performed involving 57 patients. The majority of the consultations were for trauma or wounds. All consultations comprised a digital photograph taken with the integrated camera and sent via the Multimedia Messaging Service (MMS). In 86% of the cases the residents reported that multimedia information contributed to their ability to independently handle similar cases in future. Satisfaction scores were high among all participants. We believe that a multimedia consultation in a hospital setting adds information to an ordinary telephone call, thus decreasing medico-legal risks. We recommend it for routine use.
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Affiliation(s)
- Nimrod Farber
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer 52621, Israel.
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Khan SK, Abraham A. Telesurveillance of circular frame pin sites: one year's experience at a specialist unit. J Telemed Telecare 2011; 17:210-3. [PMID: 21398388 DOI: 10.1258/jtt.2010.100618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Circular frame treatment for limb reconstruction involves repeated follow-up visits, and a substantial number of these appointments are for pin site review only. We have encouraged our frame patients to take photographs of their pin sites when they carry out their weekly dressing changes. The photographs are taken with mobile phones or digital cameras by the patients themselves, and the images sent to us by email. We reply within 24 hours, with either reassurance or appropriate instructions as indicated. In the past 12 months, five patients have had their pin sites reviewed remotely using this method, and have expressed a high level of satisfaction. These early results are encouraging.
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Affiliation(s)
- Sameer K Khan
- Department of Trauma and Orthopaedics, Leicester Royal Infirmary, UK.
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Dala-Ali BM, Lloyd MA, Al-Abed Y. The uses of the iPhone for surgeons. Surgeon 2011; 9:44-8. [PMID: 21195331 DOI: 10.1016/j.surge.2010.07.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2010] [Revised: 07/27/2010] [Accepted: 07/28/2010] [Indexed: 10/19/2022]
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Pirris SM, Monaco EA, Tyler-Kabara EC. Telemedicine through the use of digital cell phone technology in pediatric neurosurgery: a case series. Neurosurgery 2010; 66:999-1004. [PMID: 20404707 DOI: 10.1227/01.neu.0000368443.43565.2a] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Advances in medicine have largely followed advances in technology. Medical strides have been made when physicians and researchers have adapted growing science to target specific problems. A new medical field, telemedicine, has emerged that links physicians with colleagues and patients. Cell phone technology is affordable for almost everyone, and basic models include digital photography. OBJECTIVE We present a case series exhibiting the utility of digital pictures taken with patients' cell phones. CLINICAL PRESENTATION Our patients had wound infections requiring daily intravenous antibiotics and dressing changes. In years past, these patients would have required prolonged hospitalizations. In the era of managed care, patients with these infections are discharged from the hospital, but close outpatient observation is required to monitor the wound. Our patients lived up to 8 hours away from the hospital. Daily appointments for wound checks in the clinic were not practical. Wounds were thus monitored via cell phone images without the inconvenience of travel and the expense of staying in a local hotel, along with leaving appointments in the clinic available for others with new neurosurgical issues. INTERVENTION Wound evaluations were conducted with the cameras on patients' cell phones. These images were transmitted to the surgeon via text messaging and emails. CONCLUSION This application of cell phone technology has been documented previously in the literature of other specialties and could attain greater stature as a legitimate method for close outpatient observation by neurosurgeons if medicolegal issues are addressed.
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Affiliation(s)
- Stephen M Pirris
- Department of Neurosurgery, Mayo Clinic Florida, Jacksonville, Florida 32224, USA
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Martínez-Ramos C, Cerdán MT, López RS. Mobile phone-based telemedicine system for the home follow-up of patients undergoing ambulatory surgery. Telemed J E Health 2009; 15:531-7. [PMID: 19566396 DOI: 10.1089/tmj.2009.0003] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A pilot study was done to address the efficacy of a General Packet Radio Service mobile phone-based telemedicine system used to improve follow-up after ambulatory surgery. The method involves sending images of surgical wounds or other areas from the patient's home, to assess local complications and avoid unnecessary hospital visits. Ninety-six (N = 96) patients were enrolled in the study. The phone used was a Nokia 6600, which provides images in Joint Photographic Experts Group format. These images were sent via e-mail and visualized on a standard 17-inch screen of a personal computer. After the follow-up period, self-reported patient satisfaction was assessed by analyzing the replies to a 9-item questionnaire. Thirty of the 96 patients (31.3%) reported local problems including: hematoma in 20 (66.7%) patients, surgical bandage blood-stained in 7 (23.3%), exudates in 1 (3.3%), allergic skin reactions in 1 (3.3%), and bandage too tight in 1 (3.3%). In total, 225 photographs were evaluated by 3 physicians. In all cases, it was possible to identify and assess the postoperative problem with consensus among the 3 physicians. Images served to resolve patients' concerns in 20 individuals (66.7%). In 10 patients (33.3%), concerns were satisfied but it was suggested that follow-up images be sent in the following days. Only 1 patient (3.3%) was asked to visit the hospital. The telemedicine system proposed increases the efficiency of home follow-up to ambulatory surgery, avoids unnecessary hospital visits, and clearly improves patient satisfaction.
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Affiliation(s)
- Carlos Martínez-Ramos
- Department of Surgery, Faculty of Medicine, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain.
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Ahmad Z. A picture paints a thousand words—the use of 3G camera mobile telephones in managing soft tissue injuries. EUROPEAN JOURNAL OF PLASTIC SURGERY 2008. [DOI: 10.1007/s00238-008-0252-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Syed TA, Sadiq Z, Shah YR, Al-Saeed M, Wetherill MH. Role of mobile multimedia messaging service (MMS) in trauma and orthopaedic telediagnosis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2007. [DOI: 10.1007/s00590-007-0233-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ahn D, Ahn S. Problem based learning (PBL) case bank. MEDICAL TEACHER 2006; 28:744. [PMID: 17594589 DOI: 10.1080/01421590601039901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Safaie A, Mousavi SM, LaPorte RE, Goya MM, Zahraie M. Introducing a model for communicable diseases surveillance: cell phone surveillance (CPS). Eur J Epidemiol 2006; 21:627-32. [PMID: 16960650 PMCID: PMC7088106 DOI: 10.1007/s10654-006-9033-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2006] [Indexed: 11/25/2022]
Abstract
Background and goal Surveillance systems for communicable diseases are primarily passive in most countries, including Iran. Laboratory-based surveillance and use of cell phone surveillance may be a useful method. Material and method We established a new model for gathering data directly from district laboratories to regional laboratories and from them to national manager of public health laboratories by using cell phone. We assessed the coverage of Mobile and Cell phone in the laboratory Technicians, and Directors of Public Health in 27 universities in Iran by a simple data collection form to evaluate the feasibility of this method. And then this method was piloted for the last Cholera out break in Iran in 2005. Result From data of 27 universities with 184 cities, we gathered 769 data health directors’ mobile , total mobile penetrating rate, SMS users, and SMS penetrating rate was 57.9%, 77.1%, and 44.6% between Directors in Medical Universities of Iran and 54.5%, 54.9% and 29.9% in Directors of Laboratory. In the Cholera epidemic in Iran in summer 2005, CDC of MOH registered near 900 cases of cholera from 70000 rectal soap’s exam in whole of country. The median reporting interval was under one day. Conclusion Although the advent of the cell phone will probably change the way in which surveillance is delivered by health system, further studies are warranted to evaluate this method for laboratory based surveillance of lethal infections.
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Affiliation(s)
- Afshin Safaie
- Center for disease control and prevention, Ministry of health, Tehran, Iran
| | - Seyed Mohsen Mousavi
- Cancer research center, Cancer institute, MAHAK, Medical/Rehabilitation complex, Darabad, Tehran, Iran
- Cancer research center, Cancer institute, MAHAK, Medical/Rehabilitation complex, Oshan Blv. Lashkarak Road, P.O. Box 19395-5445, Darabad, Tehran, Iran
| | - Ronald E. LaPorte
- Disease Monitoring and Telecommunications, WHO Collaborating Center, Pittsburgh, USA
| | | | - Mohsen Zahraie
- Center for disease control and prevention, Ministry of health, Tehran, Iran
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Bajaj Y, Crampsey D, Hartley B. The use of camera mobile phone to assess emergency ENT radiological investigations. Clin Otolaryngol 2005; 30:573; author reply 574. [PMID: 16402996 DOI: 10.1111/j.1749-4486.2005.01095.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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