Patient-generated Digital Images after Pediatric Ambulatory Surgery

Matthew W. Miller; Rachael K. Ross; Christina Voight; Heather Brouwer; Dean J. Karavite; Jeffrey S. Gerber; Robert W. Grundmeier; Susan E. Coffin

doi:10.4338/ACI-2015-12-CR-0168

Applied Clinical Informatics, Table of Contents

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

Authors

Matthew W. Miller

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
Rachael K. Ross

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
Christina Voight

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
Heather Brouwer

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania
Dean J. Karavite

³Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Jeffrey S. Gerber

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania

²Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

⁴Center of Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Robert W. Grundmeier

²Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

³Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
Susan E. Coffin

¹Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania

²Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania

⁴Center of Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Abstract

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

Full Text

References

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