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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
› Author AffiliationsBrandon Putz and Cory Matchulat performed data collection for this study, which was crucial to the success of this report.
Further Information

Publication History

received: 01 December 2015

accepted: 04 May 2016

Publication Date:
19 December 2017 (online)

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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

Keywords

Ambulatory care information systems - patient records - surgery - workflow - clinical images
 

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