title: Smart phones make smart referrals: The use of mobile phone technology in burn care - A retrospective case series.
abstract: Telemedicine using cellular phones allows for real-time consultation of burn patients seen at distant hospitals.
  
  
  METHODS
  Telephonic consultations to our unit have required completion of a proforma, to ensure collection of the following information: demographics, mechanism of injury, vital signs, relevant laboratory data, management at the referring hospital and advice given by the burn team. Since December 2014 we have required referring doctors to send photographs of the burn wounds to the burns specialist before making a decision on acceptance of the referral or providing management advice. The photographs are taken and sent by smartphone using MMS or WhatsApp. The cases, with photographs, are entered into a database of telemedicine consultations which we have retrospectively reviewed.
  
  
  RESULTS
  During the study period (December 2014-July 2015) we were consulted about 119 patients, in 100 of whom the telemedicine consultation was completed. Inappropriate transfer to the burns centre was avoided in 38% of cases, and in 28% a period of treatment in the referral hospital was advised before transfer. For a total of 66% of patients the telemedicine consultation changed, and either avoided an inappropriate admission, or delayed admission in late referrals until the patient was ready for definitive treatment.
  
  
  CONCLUSIONS
  We conclude that telemedicine consultations using a cellular phone significantly change referral pathways in burns.
authors: Burns Unit, Inkosi Albert Luthuli Central Hospital, Department of Surgery, University of KwaZulu-Natal, South Africa. Electronic address: daanhol@ialch.co.za.
authors: Daan
authors: D
authors: den Hollander
authors: Department of Telemedicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors: Maurice
authors: M
authors: Mars
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D002053:Burn Units; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control; D063731:Mobile Applications; D010360:Patient Transfer; D010781:Photography; D012017:Referral and Consultation; D012189:Retrospective Studies; D000068997:Smartphone; D013019:South Africa; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging; D014218:Triage / Q000379:methods*
keywords: Burns; Decision making; Mhealth; Smartphone; Telemedicine