Teleconsultation with the mobile camera-phone in digital soft-tissue injury: a feasibility study.

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dc.contributor.authorHsieh, Ching-Hua
dc.contributor.authorTsai, Hui-Hong
dc.contributor.authorYin, Jir-Wen
dc.contributor.authorChen, Chih-Yuan
dc.contributor.authorYang, Johnson Chia-Shen
dc.contributor.authorJeng, Seng-Feng
dc.date.accessioned2020-02-06T18:08:10Z
dc.date.available2020-02-06T18:08:10Z
dc.date.issued2004-12-03
dc.description.abstractThe purpose of this study was to examine the feasibility of teleconsultation using a mobile camera phone to evaluate the severity of digital soft tissue injury and to triage the injury with regard to management recommendations With a built in 110 000 pixel digital camera pictures of the injured digit s or radiograph were taken by surgical residents in the emergency room and transmitted to another camera phone to be viewed by the remote consultant surgeon A brief medical and trauma history of each patient was relayed also by mobile phone The consultant surgeon then reviewed all of these patients in the emergency room shortly after the initial telemedicine referral Separate triaging for each digital injury into three groups was recorded during remote teleconsultation and according to actual treatment by the attending surgeon as follows group I the injury could be managed with conservative treatment such as secondary intention wound healing or primary closure with or without bone shortening group II skin grafting or local flap coverage was required for management of the injury and group III microsurgery such as replantation or free flap coverage was necessary to deal with the injury Later triaging was also performed individually by three junior plastic residents according to image review and patient referral information Teleconsultation through a mobile camera phone was performed for 45 patients with injuries of 81 digits from January to May of 2003 Of these 81 digital injuries there were 12 cases 15 percent where disagreement of triaging occurred between the teleconsultation and the actual treatment by the attending surgeon In image reviewing there was 79 percent sensitivity and 71 percent specificity in remote diagnosis of the skin defect and 76 percent sensitivity and 75 percent specificity in remote identification of the bone exposure regarding the concordance of opinions of all three surgeons there was significant discordance in triaging in 20 cases 25 percent and the difference in triaging was partly attributed to the inability to show instances of tiny exposed digital bone or tendon in some cases under the low resolution digital image and the situation of a bloody oozing wound In some cases the difficulty in evaluating the probability of primary closure of severely avulsed skin edges or the probability of executing replantation for finger amputation also contributed to different triaging outcomes Two neglected diagnoses of transected digital nerves were found and influenced triaging highlighting the importance of on site physical examination during teleconsultation The telemedicine system using a mobile camera phone based on the global system for mobile communication is feasible and valuable for early diagnosis and triaging of digital soft tissue injury in emergency cases with on line verbal communication and review of the transmitted captured image This system has the advantages of ease of use low cost high portability and mobility With advances in hardware for digital imaging and transmission technology and the development of the third generation advanced mobile phone system in the foreseeable future this system has potential for future applications in telemedicine and telecare
dc.identifier.urihttp://dx.doi.org/Not available
dc.identifier.urihttps://lib.digitalsquare.io/xmlui/handle/123456789/6079
dc.relation.uriPlastic and reconstructive surgery
dc.subjectFacility-based health worker
dc.subjectAccess to information or data
dc.subjectTimeliness of care
dc.subjectPlanning and coordination
dc.subjectPilot
dc.subjectFeasibility
dc.subjectUnintentional injury
dc.subjectAcute or emergency
dc.subjectDisease diagnosis / Point-of-care diagnostics
dc.subjectProvider-to-provider communication
dc.subjectReferrals
dc.subjectImage
dc.titleTeleconsultation with the mobile camera-phone in digital soft-tissue injury: a feasibility study.en
dcterms.abstractThe purpose of this study was to examine the feasibility of teleconsultation using a mobile camera phone to evaluate the severity of digital soft tissue injury and to triage the injury with regard to management recommendations With a built in 110 000 pixel digital camera pictures of the injured digit s or radiograph were taken by surgical residents in the emergency room and transmitted to another camera phone to be viewed by the remote consultant surgeon A brief medical and trauma history of each patient was relayed also by mobile phone The consultant surgeon then reviewed all of these patients in the emergency room shortly after the initial telemedicine referral Separate triaging for each digital injury into three groups was recorded during remote teleconsultation and according to actual treatment by the attending surgeon as follows group I the injury could be managed with conservative treatment such as secondary intention wound healing or primary closure with or without bone shortening group II skin grafting or local flap coverage was required for management of the injury and group III microsurgery such as replantation or free flap coverage was necessary to deal with the injury Later triaging was also performed individually by three junior plastic residents according to image review and patient referral information Teleconsultation through a mobile camera phone was performed for 45 patients with injuries of 81 digits from January to May of 2003 Of these 81 digital injuries there were 12 cases 15 percent where disagreement of triaging occurred between the teleconsultation and the actual treatment by the attending surgeon In image reviewing there was 79 percent sensitivity and 71 percent specificity in remote diagnosis of the skin defect and 76 percent sensitivity and 75 percent specificity in remote identification of the bone exposure regarding the concordance of opinions of all three surgeons there was significant discordance in triaging in 20 cases 25 percent and the difference in triaging was partly attributed to the inability to show instances of tiny exposed digital bone or tendon in some cases under the low resolution digital image and the situation of a bloody oozing wound In some cases the difficulty in evaluating the probability of primary closure of severely avulsed skin edges or the probability of executing replantation for finger amputation also contributed to different triaging outcomes Two neglected diagnoses of transected digital nerves were found and influenced triaging highlighting the importance of on site physical examination during teleconsultation The telemedicine system using a mobile camera phone based on the global system for mobile communication is feasible and valuable for early diagnosis and triaging of digital soft tissue injury in emergency cases with on line verbal communication and review of the transmitted captured image This system has the advantages of ease of use low cost high portability and mobility With advances in hardware for digital imaging and transmission technology and the development of the third generation advanced mobile phone system in the foreseeable future this system has potential for future applications in telemedicine and telecare
dcterms.contributorHsieh, Ching-Hua
dcterms.contributorTsai, Hui-Hong
dcterms.contributorYin, Jir-Wen
dcterms.contributorChen, Chih-Yuan
dcterms.contributorYang, Johnson Chia-Shen
dcterms.contributorJeng, Seng-Feng
dcterms.identifierhttp://dx.doi.org/Not available
dcterms.relationPlastic and reconstructive surgery
dcterms.subjectFacility-based health worker
dcterms.subjectAccess to information or data
dcterms.subjectTimeliness of care
dcterms.subjectPlanning and coordination
dcterms.subjectPilot
dcterms.subjectFeasibility
dcterms.subjectUnintentional injury
dcterms.subjectAcute or emergency
dcterms.subjectDisease diagnosis / Point-of-care diagnostics
dcterms.subjectProvider-to-provider communication
dcterms.subjectReferrals
dcterms.subjectImage
dcterms.titleTeleconsultation with the mobile camera-phone in digital soft-tissue injury: a feasibility study.en
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