title: The use of multi-media messaging in the referral of musculoskeletal limb injuries to a tertiary trauma unit using: a 1-month evaluation.
abstract: OBJECTIVE
  New developments in telecommunications will have a profound effect on the delivery of medical care throughout the world. In Northern Ireland three trauma centres provide fracture care for their own and surrounding Emergency Departments. All trauma referrals are currently taken by telephone. It is our experience that the verbal description of the radiographs of a musculoskeletal limb injury can be inaccurate, necessitating us to view the plain films of the patient. By utilising a recent advance in telecommunications technology, the launch of mobile handsets with multi-media messaging (MMS) service capability, it is now possible to digitally capture and instantly send an image of a plain film.
  
  
  OBJECTIVE
  To evaluate the use of multi-media messaging as a supplement to the telephone referral of musculoskeletal limb injures.
  
  
  METHODS
  : Following a referral using, the emergency physician and the trauma surgeon evaluated the multi-media consult through a survey questionnaire.
  
  
  RESULTS
  Between the 1st December 2003 and the 1st January 2004, 46 multi-media consultations were performed. Picture quality was acceptable in all but one of the referrals. In 35 of the 46 referrals the multi-media image of the plain films was felt to improve the management of the patient. In 8 of the 46 referrals the multi-media image of the plain films was felt to change the management of the patient.
  
  
  CONCLUSIONS
  A multi-media messaging store- and forward telemedicine system has potential to facilitate the rapid, cost-effective management of musculoskeletal limb injuries thereby enhancing clinical care.
authors.affiliation: Orthopaedic Unit, Altnagelvin Hospital, Glenshane Road, Londonderry, Northern Ireland, UK. poolerarchbold@aol.com
authors.forename: H A P
authors.initials: HA
authors.lastname: Archbold
authors.forename: A R
authors.initials: AR
authors.lastname: Guha
authors.forename: S
authors.initials: S
authors.lastname: Shyamsundar
authors.forename: S J
authors.initials: SJ
authors.lastname: McBride
authors.forename: P
authors.initials: P
authors.lastname: Charlwood
authors.forename: R
authors.initials: R
authors.lastname: Wray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001134:Arm Injuries / Q000000981:diagnostic imaging* / Q000628:therapy; D040421:Cell Phone; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D007869:Leg Injuries / Q000000981:diagnostic imaging* / Q000628:therapy; D008875:Middle Aged; D009660:Northern Ireland; D011787:Quality of Health Care; D011859:Radiography; D012017:Referral and Consultation; D013689:Telephone; D019112:Teleradiology / Q000295:instrumentation* / Q000379:methods