title: Telemedicine through the use of digital cell phone technology in pediatric neurosurgery: a case series.
abstract: BACKGROUND
  Advances in medicine have largely followed advances in technology. Medical strides have been made when physicians and researchers have adapted growing science to target specific problems. A new medical field, telemedicine, has emerged that links physicians with colleagues and patients. Cell phone technology is affordable for almost everyone, and basic models include digital photography.
  
  
  OBJECTIVE
  We present a case series exhibiting the utility of digital pictures taken with patients' cell phones.
  
  
  METHODS
  Our patients had wound infections requiring daily intravenous antibiotics and dressing changes. In years past, these patients would have required prolonged hospitalizations. In the era of managed care, patients with these infections are discharged from the hospital, but close outpatient observation is required to monitor the wound. Our patients lived up to 8 hours away from the hospital. Daily appointments for wound checks in the clinic were not practical. Wounds were thus monitored via cell phone images without the inconvenience of travel and the expense of staying in a local hotel, along with leaving appointments in the clinic available for others with new neurosurgical issues.
  
  
  METHODS
  Wound evaluations were conducted with the cameras on patients' cell phones. These images were transmitted to the surgeon via text messaging and emails.
  
  
  CONCLUSIONS
  This application of cell phone technology has been documented previously in the literature of other specialties and could attain greater stature as a legitimate method for close outpatient observation by neurosurgeons if medicolegal issues are addressed.
authors.affiliation: Department of Neurosurgery, Mayo Clinic Florida, Jacksonville, Florida 32224, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Pirris
authors.forename: Edward A
authors.initials: EA
authors.lastname: Monaco
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Tyler-Kabara
mesh_terms: D000293:Adolescent; D040421:Cell Phone / Q000639:trends; D002648:Child; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009493:Neurosurgery / Q000379:methods* / Q000639:trends; D010781:Photography / Q000379:methods*; D011183:Postoperative Complications / Q000473:pathology; D017216:Telemedicine / Q000379:methods* / Q000639:trends; D014946:Wound Infection / Q000473:pathology* / Q000628:therapy