Appl Clin Inform 2016; 07(03): 646-652
DOI: 10.4338/ACI-2015-12-CR-0168
Case Report
Schattauer GmbH

Patient-generated Digital Images after Pediatric Ambulatory Surgery

Matthew W. Miller
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
,
Rachael K. Ross
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
,
Christina Voight
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
,
Heather Brouwer
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
,
Dean J. Karavite
3   Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Jeffrey S. Gerber
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
2   Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
4   Center of Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Robert W. Grundmeier
2   Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
3   Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
,
Susan E. Coffin
1   Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
2   Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
4   Center of Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
› Institutsangaben
Brandon Putz and Cory Matchulat performed data collection for this study, which was crucial to the success of this report.
Weitere Informationen

Correspondence to

Matthew Miller, BS
Clinical Research Assistant
The Children’s Hospital of Philadelphia
3535 Market Street
Suite 1512
Philadelphia
PA 19104
Telefon: 215.590.3289   

Publikationsverlauf

received: 01. Dezember 2015

accepted: 04. Mai 2016

Publikationsdatum:
19. Dezember 2017 (online)

 

Summary

Objective

To describe the use of digital images captured by parents or guardians and sent to clinicians for assessment of wounds after pediatric ambulatory surgery.

Methods

Subjects with digital images of post-operative wounds were identified as part of an ongoing cohort study of infections after ambulatory surgery within a large pediatric healthcare system. We performed a structured review of the electronic health record (EHR) to determine how digital images were documented in the EHR and used in clinical care.

Results

We identified 166 patients whose parent or guardian reported sending a digital image of the wound to the clinician after surgery. A corresponding digital image was located in the EHR in only 121 of these encounters. A change in clinical management was documented in 20% of these encounters, including referral for in-person evaluation of the wound and antibiotic prescription.

Conclusion

Clinical teams have developed ad hoc workflows to use digital images to evaluate post-operative pediatric surgical patients. Because the use of digital images to support follow-up care after ambulatory surgery is likely to increase, it is important that high-quality images are captured and documented appropriately in the EHR to ensure privacy, security, and a high-level of care.

Citation: Miller MW; Ross RK; Voight C; Brouwer H; Karavite DJ; Gerber JS; Grundmeier RW; Coffin SE. Patient-generated Digital Images after Pediatric Ambulatory Surgery


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Conflict of Interest

No author had any conflicts of interest regarding this study.

  • References

  • 1 Munnich EL, Parente ST. Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up. Health Affair 2014; 33 (05) 764-769.
  • 2 Hwa K, Wren SM. Telehealth follow-up in lieu of postoperative clinic visit for ambulatory surgery: results of a pilot program. JAMA Surg 2013; 148 (09) 823-827.
  • 3 Wasson J, Gaudette C, Waley F, Sauvigne A, Baribeau P, Welch HG. Telephone Care as a Substitute for Routine Clinic Follow-up. JAMA 1992; 267 (13) 1788-1793.
  • 4 Kassmann BP, Docherty SL, Rice HE, Bailey DE, Schweitzer M. Telephone Follow-up for Pediatric Ambulatory Surgery: Parent and Provider Satisfaction. J Pediatr Nurs 2012; 27 (06) 715-724.
  • 5 McVay MR, Kelley KR, Mathews DL, Jackson RJ, Kokoska ER, Smith SD. Postoperative follow-up: is a phone call enough?. J Pediatr Surg 2008; 43 (01) 83-86.
  • 6 Hsieh C-H, Tsai H-H, Yin J-W, Chen C-Y, Yang JC-S, Jeng S-F. Teleconsultation with the Mobile Camera-Phone in Digital Soft-Tissue Injury: A Feasibility Study. Plast Reconstr Surg 2004; 114 (07) 1776-1782.
  • 7 Wiseman JT, Fernandes-Taylor S, Barnes ML, Tomsejova A, Saunders RS, Kent KC. Conceptualizing smartphone use in outpatient wound assessment: patients’ and caregivers’ willingness to use technology. J Surg Res 2015; 198 (01) 245-251.
  • 8 Roth AC, Reid JC, Puckett CL, Concannon MJ. Digital Images in the Diagnosis of Wound Healing Problems. Plast Reconstr Surg 1999; 103 (02) 483-486.
  • 9 Braun RP, Vecchietti JL, Thomas L, Prins C, French LE, Gewirtzman AJ, Saurat JH, Salomon D. Telemedical Wound Care Using a New Generation of Mobile Telephones. Arch Dermatol 2005; 141 (02) 254-258.
  • 10 Wirthlin DJ, Buradagunta S, Edwards RA, Brewster DC, Cambria RP, Gertler JP, LaMuraglia GM, Jordan De, Kvedar JC, Abbott WM. Telemedicine in vascular surgery-: Feasibility of digital imaging for remote management of wounds. J Vasc Surg 1998; 27 (06) 1089-1100.
  • 11 Landman A, Emani S, Carlile N, Rosenthal DI, Semakov S, Pallin DJ, Poon EG. A Mobile App for Securely Capturing and Transferring Clinical Images to the Electronic Health Record-: Description and Preliminary Usability Study. JMIR mHealth uHealth 2015; 03 (01) 1-8.
  • 12 Dala-Ali BM, Lloyd MA, Al-Abed Y. The uses of the iPhone for surgeons. Surgeon Surg 2011; 09 (01) 44-48.
  • 13 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.
  • 14 Beard HR, Hamid KS. Worth a thousand words: Integrating clinical photographs into an electronic medical record. Healthc 2014; 02 (01) 22-25.

Correspondence to

Matthew Miller, BS
Clinical Research Assistant
The Children’s Hospital of Philadelphia
3535 Market Street
Suite 1512
Philadelphia
PA 19104
Telefon: 215.590.3289   

  • References

  • 1 Munnich EL, Parente ST. Procedures take less time at ambulatory surgery centers, keeping costs down and ability to meet demand up. Health Affair 2014; 33 (05) 764-769.
  • 2 Hwa K, Wren SM. Telehealth follow-up in lieu of postoperative clinic visit for ambulatory surgery: results of a pilot program. JAMA Surg 2013; 148 (09) 823-827.
  • 3 Wasson J, Gaudette C, Waley F, Sauvigne A, Baribeau P, Welch HG. Telephone Care as a Substitute for Routine Clinic Follow-up. JAMA 1992; 267 (13) 1788-1793.
  • 4 Kassmann BP, Docherty SL, Rice HE, Bailey DE, Schweitzer M. Telephone Follow-up for Pediatric Ambulatory Surgery: Parent and Provider Satisfaction. J Pediatr Nurs 2012; 27 (06) 715-724.
  • 5 McVay MR, Kelley KR, Mathews DL, Jackson RJ, Kokoska ER, Smith SD. Postoperative follow-up: is a phone call enough?. J Pediatr Surg 2008; 43 (01) 83-86.
  • 6 Hsieh C-H, Tsai H-H, Yin J-W, Chen C-Y, Yang JC-S, Jeng S-F. Teleconsultation with the Mobile Camera-Phone in Digital Soft-Tissue Injury: A Feasibility Study. Plast Reconstr Surg 2004; 114 (07) 1776-1782.
  • 7 Wiseman JT, Fernandes-Taylor S, Barnes ML, Tomsejova A, Saunders RS, Kent KC. Conceptualizing smartphone use in outpatient wound assessment: patients’ and caregivers’ willingness to use technology. J Surg Res 2015; 198 (01) 245-251.
  • 8 Roth AC, Reid JC, Puckett CL, Concannon MJ. Digital Images in the Diagnosis of Wound Healing Problems. Plast Reconstr Surg 1999; 103 (02) 483-486.
  • 9 Braun RP, Vecchietti JL, Thomas L, Prins C, French LE, Gewirtzman AJ, Saurat JH, Salomon D. Telemedical Wound Care Using a New Generation of Mobile Telephones. Arch Dermatol 2005; 141 (02) 254-258.
  • 10 Wirthlin DJ, Buradagunta S, Edwards RA, Brewster DC, Cambria RP, Gertler JP, LaMuraglia GM, Jordan De, Kvedar JC, Abbott WM. Telemedicine in vascular surgery-: Feasibility of digital imaging for remote management of wounds. J Vasc Surg 1998; 27 (06) 1089-1100.
  • 11 Landman A, Emani S, Carlile N, Rosenthal DI, Semakov S, Pallin DJ, Poon EG. A Mobile App for Securely Capturing and Transferring Clinical Images to the Electronic Health Record-: Description and Preliminary Usability Study. JMIR mHealth uHealth 2015; 03 (01) 1-8.
  • 12 Dala-Ali BM, Lloyd MA, Al-Abed Y. The uses of the iPhone for surgeons. Surgeon Surg 2011; 09 (01) 44-48.
  • 13 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.
  • 14 Beard HR, Hamid KS. Worth a thousand words: Integrating clinical photographs into an electronic medical record. Healthc 2014; 02 (01) 22-25.