Experiences of Health Care Providers Using a Mobile Medical Photography Application

Abstract

Objective To understand the ways in which providers use a mobile photography application integrated with the electronic health record (EHR) to facilitate clinical care, and the process outcomes that result from the application's use.

Methods An e-mail survey was sent on November 13, 2017, to 1,463 health care providers at Mayo Clinic who had used an internally developed, EHR-integrated medical photography application.

Results The survey was completed by 712 (49%) providers. Providers reported using the application on approximately 1 in 7 days spent in clinical practice. Median provider satisfaction with the use of the application (0–100 scale; higher numbers indicate favorable response) was 94 (interquartile range [IQR]: 74–100). Although the use for store-and-forward telemedicine was reported (22% often or frequently used the application to send photographs to a specialist for advice), the most common use was for clinical documentation (65% often or frequently used the application to supplement text-based notes with photographs, and 71% often or frequently used the application to take photographs for reference by a colleague who may see the patient in the future). Of the health care providers, 36% indicated that the application's use often or frequently expedited treatment.

Discussion Health care providers reported using a mobile point-of-care medical photography application regularly in clinical practice and were generally satisfied with the application.

Conclusion Point-of-care medical photography using a secure mobile, EHR-integrated application has potential to become a new standard of care for clinical documentation and may facilitate continuity across the continuum of care with multiple providers who see a patient.

Keywords

medical photography - photography - mobile application

Protection of Human and Animal Subjects

The survey was reviewed by the Mayo Clinic Institutional Review Board, but it was deemed “not research,” as it was a quality improvement initiative that aimed to gather data on local processes, with the goal of assessing and improving the application's use and clinical impact within our practice.

• References

• 1 Sittig DF, Wright A, Ash J, Singh H. New unintended adverse consequences of electronic health records. Yearb Med Inform 2016; (01) 7-12
• 2 Guo U, Chen L, Mehta PH. Electronic health record innovations: helping physicians - one less click at a time. Health Inf Manag 2017; 46 (03) 140-144
• 3 Khairat S, Burke G, Archambault H, Schwartz T, Larson J, Ratwani RM. Perceived burden of EHRs on physicians at different stages of their career. Appl Clin Inform 2018; 9 (02) 336-347
• 4 Harris DA, Haskell J, Cooper E, Crouse N, Gardner R. Estimating the association between burnout and electronic health record-related stress among advanced practice registered nurses. Appl Nurs Res 2018; 43: 36-41
• 5 Tutty MA, Carlasare LE, Lloyd S, Sinsky CA. The complex case of EHRs: examining the factors impacting the EHR user experience. J Am Med Inform Assoc 2019; 26 (07) 673-677
• 6 Mounessa JS, Chapman S, Braunberger T. , et al. A systematic review of satisfaction with teledermatology. J Telemed Telecare 2018; 24 (04) 263-270
• 7 Cronin RM, Conway D, Condon D, Jerome RN, Byrne DW, Harris PA. Patient and healthcare provider views on a patient-reported outcomes portal. J Am Med Inform Assoc 2018; 25 (11) 1470-1480
• 8 Andrews AL, Nitchie HL, Harvey JB. Parent preferences for methods and content of mobile technology-based asthma medication adherence intervention. Hosp Pediatr 2019; 9 (03) 209-215
• 9 Hou C, Carter B, Hewitt J, Francisa T, Mayor S. Do mobile phone applications improve glycemic control (HbA1c) in the self-management of diabetes? A systematic review, meta-analysis, and GRADE of 14 randomized trials. Diabetes Care 2016; 39 (11) 2089-2095
• 10 Cui M, Wu X, Mao J, Wang X, Nie M. T2DM self-management via smartphone applications: a systematic review and meta-analysis. PLoS One 2016; 11 (11) e0166718
• 11 Wisniewski H, Liu G, Henson P. , et al. Understanding the quality, effectiveness and attributes of top-rated smartphone health apps. Evid Based Ment Health 2019; 22 (01) 4-9
• 12 Byambasuren O, Sanders S, Beller E, Glasziou P. Prescribable mHealth apps identified from an overview of systematic reviews. NPJ Digit Med 2018; 1: 12
• 13 Wilson GM. Early photography, goitre, and James Inglis. BMJ 1973; 2 (5858): 104-105
• 14 Cheung A, Al-Ausi M, Hathorn I, Hyam J, Jaye P. Patients' attitudes toward medical photography in the emergency department. Emerg Med J 2005; 22 (08) 609
• 15 Kunde L, McMeniman E, Parker M. Clinical photography in dermatology: ethical and medico-legal considerations in the age of digital and smartphone technology. Australas J Dermatol 2013; 54 (03) 192-197
• 16 Chan N, Charette J, Dumestre DO, Fraulin FO. Should ‘smart phones’ be used for patient photography?. Plast Surg (Oakv) 2016; 24 (01) 32-34
• 17 Sandler J, Gutierrez RJ, Murray A. Clinical photographs: the gold standard, an update. Prog Orthod 2012; 13 (03) 296-303
• 18 Morse GA, Haque MS, Sharland MR, Burke FJ. The use of clinical photography by UK general dental practitioners. Br Dent J 2010; 208 (01) E1
• 19 Aveta A, Filoni A, Persichetti P. Digital photography in plastic surgery: the importance of standardization in the era of medicolegal issues. Plast Reconstr Surg 2012; 130 (03) 490e-491e
• 20 Accetta JL, Schoenfeld J, Bitar C, Murina A. Smartphones in dermatology: acceptance of smartphone photography by the informed patient. Dermatol Surg 2019 Doi: 10.1097/DSS.0000000000001976
• 21 Hsieh C, Yun D, Bhatia AC, Hsu JT, Ruiz de Luzuriaga AM. Patient perception on the usage of smartphones for medical photography and for reference in dermatology. Dermatol Surg 2015; 41 (01) 149-154
• 22 Wyatt KD, Willaert BN, Pallagi PJ, Uribe RA, Yiannias JA, Hellmich TR. PhotoExam: adoption of an iOS-based clinical image capture application at Mayo Clinic. Int J Dermatol 2017; 56 (12) 1359-1365
• 23 Pecina JL, Wyatt KD, Comfere NI, Bernard ME, North F. Uses of mobile device digital photography of dermatologic conditions in primary care. JMIR Mhealth Uhealth 2017; 5 (11) e165
• 24 Kameda-Smith MM, Iorio-Morin C, Winkler-Schwartz A. , et al; Canadian Neurosurgery Research Collaborative (CNRC). Smartphone usage patterns by Canadian neurosurgery residents: a national cross-sectional survey. World Neurosurg 2018; 111: e465-e470
• 25 Li MK, Howard DP, King R. “A picture tells a thousand words” smartphone-based secure clinical image transfer improves compliance in open fracture management. Injury 2019; 50 (07) 1284-1287
• 26 Ai AC, Maloney FL, Hickman TT, Wilcox AR, Ramelson H, Wright A. ; The Use of Clinical Images in Electronic Medical Records. A picture is worth 1,000 words. Appl Clin Inform 2017; 8 (03) 710-718
• 27 Landman A, Emani S, Carlile N. , et al. A mobile app for securely capturing and transferring clinical images to the electronic health record: description and preliminary usability study. JMIR Mhealth Uhealth 2015; 3 (01) e1
• 28 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
• 29 Leger MC, Wu T, Haimovic A. , et al. Patient perspectives on medical photography in dermatology. Dermatol Surg 2014; 40 (09) 1028-1037
• 30 Cunningham CT, Quan H, Hemmelgarn B. , et al. Exploring physician specialist response rates to web-based surveys. BMC Med Res Methodol 2015; 15: 32
• 31 Hardigan PC, Popovici I, Carvajal MJ. Response rate, response time, and economic costs of survey research: a randomized trial of practicing pharmacists. Res Social Adm Pharm 2016; 12 (01) 141-148
• 32 Cook DA, Wittich CM, Daniels WL, West CP, Harris AM, Beebe TJ. Incentive and reminder strategies to improve response rate for internet-based physician surveys: a randomized experiment. J Med Internet Res 2016; 18 (09) e244
• 33 Miller MW, Ross RK, Voight C. , et al. Patient-generated digital images after pediatric ambulatory surgery. Appl Clin Inform 2016; 7 (03) 646-652