title: A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care.
abstract: BACKGROUND
  Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back.
  
  
  RESULTS
  The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s) through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care.
  
  
  CONCLUSIONS
  In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be integrated into routine acute clinical care and thereby promote equity in injury emergency care, a growing public health burden.
authors.affiliation: Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Lee A
authors.initials: LA
authors.lastname: Wallis
authors.affiliation: Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa.
authors.forename: Julian
authors.initials: J
authors.lastname: Fleming
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Marais Street, Stellenbosch 7600, South Africa.
authors.forename: Marie
authors.initials: M
authors.lastname: Hasselberg
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Marais Street, Stellenbosch 7600, South Africa.|University of South Africa, Preller Street, Pretoria 0002, South Africa.
authors.forename: Lucie
authors.initials: L
authors.lastname: Laflamme
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Tukholmankatu 8, FI-00290, Helsinki, Finland.
authors.forename: Johan
authors.initials: J
authors.lastname: Lundin
mesh_terms: D001830:Body Surface Area; D002056:Burns / Q000175:diagnosis / Q000628:therapy*; D000067917:Cloud Computing; D004632:Emergency Medical Services; D006801:Humans; D063731:Mobile Applications; D019095:Point-of-Care Systems; D019114:Remote Consultation; D000068997:Smartphone; D060145:Text Messaging