title: Patient-generated Digital Images after Pediatric Ambulatory Surgery.
abstract: To describe the use of digital images captured by parents or guardians and sent to clinicians for assessment of wounds after pediatric ambulatory surgery.
  
  
  
  Subjects with digital images of post-operative wounds were identified as part of an on-going cohort study of infections after ambulatory surgery within a large pediatric healthcare system. We performed a structured review of the electronic health record (EHR) to determine how digital images were documented in the EHR and used in clinical care.
  
  
  
  We identified 166 patients whose parent or guardian reported sending a digital image of the wound to the clinician after surgery. A corresponding digital image was located in the EHR in only 121 of these encounters. A change in clinical management was documented in 20% of these encounters, including referral for in-person evaluation of the wound and antibiotic prescription.
  
  
  
  Clinical teams have developed ad hoc workflows to use digital images to evaluate post-operative pediatric surgical patients. Because the use of digital images to support follow-up care after ambulatory surgery is likely to increase, it is important that high-quality images are captured and documented appropriately in the EHR to ensure privacy, security, and a high-level of care.
authors.affiliation: Matthew Miller, BS, Clinical Research Assistant, The Children's Hospital of Philadelphia, 3535 Market Street, Suite 1512, Philadelphia, PA 19104, Phone: 215.590.3289, Email: millerm12@email.chop.edu.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Miller
authors.forename: Rachael K
authors.initials: RK
authors.lastname: Ross
authors.forename: Christina
authors.initials: C
authors.lastname: Voight
authors.forename: Heather
authors.initials: H
authors.lastname: Brouwer
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Karavite
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Gerber
authors.forename: Robert W
authors.initials: RW
authors.lastname: Grundmeier
authors.forename: Susan E
authors.initials: SE
authors.lastname: Coffin
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D002648:Child; D002675:Child, Preschool; D000066491:Clinical Decision-Making; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007223:Infant; D007872:Legal Guardians; D008297:Male; D010290:Parents; D057566:Self Report
keywords: Ambulatory care information systems; clinical images; patient records; surgery; workflow