Telephotography in trauma: a 2-year clinical experience.
BACKGROUND
Smartphones can be used to record and transmit high-quality clinical photographs. The aim of this study was to describe our experience with smartphone telephotography in the care of trauma patients. We hypothesized that smartphone telephotography can be safely and effectively implemented on a trauma service.


METHODS
We performed a 2-year (January 2011-December 2012) prospective analysis of all patient photographs recorded by members of our trauma team at our Level I trauma center. All members of the trauma team recorded patient photographs and e-mailed them to a secure e-mail account. An administrative assistant uploaded a copy of each photgrapho into the patient's electronic medical record. We assessed the number of photographs collected and uploaded, as well as the success, failure, and complication rates.


RESULTS
Our trauma team sent 7,200 photographs to a secure e-mail account. Of those, 6,120 (85%) were considered, after an initial review, to be of good quality. Of these, 3,320 photographs (54%) were successfully uploaded into a patient's electronic medical record; the remaining 2,800 photographs lacked adequate labeling and could not be uploaded. The average interval to uploading was 3 months. In total, 10 photographs were uploaded into the wrong patient's electronic medical record, for an error rate of 0.003%. We received only three complaints during the study period.


CONCLUSIONS
Telephotography can be safely and effectively implemented in trauma clinical practice. Fears of Health Insurance Portability and Accountability Act violations are not valid, as the incidence of patient complaints is minimal when telephotography is implemented under strict guidelines and rules. Dedicated administrative personnel are essential for effective implementation of smartphone photography.
1 Division of Trauma, Critical Care, Emergency Surgery, and Burns, The University of Arizona Medical Center , Tucson, Arizona.
Bellal
B
Joseph
Viraj
V
Pandit
Julie
J
Wynne
Hassan
H
Aziz
Andrew
A
Tang
Narong
N
Kulvatunyou
Arvie
A
Webster
Terence
T
O'Keeffe
Michelle
M
Ziemba
Randall S
RS
Friese
Ronald S
RS
Weinstein
Peter
P
Rhee
D040421:Cell Phone; D016494:Computer Security; D057286:Electronic Health Records; D034742:Electronic Mail; D005260:Female; D006801:Humans; D008297:Male; D010781:Photography; D011446:Prospective Studies; D014193:Trauma Centers