title: Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts.
abstract: BACKGROUND
  Mobile health has promising potential in improving healthcare delivery by facilitating access to expert advice. Enabling experts to review images on their smartphone or tablet may save valuable time. This study aims at assessing whether images viewed by medical specialists on handheld devices such as smartphones and tablets are perceived to be of comparable quality as when viewed on a computer screen.
  
  
  METHODS
  This was a prospective study comparing the perceived quality of 18 images on three different display devices (smartphone, tablet and computer) by 27 participants (4 burn surgeons and 23 emergency medicine specialists). The images, presented in random order, covered clinical (dermatological conditions, burns, ECGs and X-rays) and non-clinical subjects and their perceived quality was assessed using a 7-point Likert scale. Differences in devices' quality ratings were analysed using linear regression models for clustered data adjusting for image type and participants' characteristics (age, gender and medical specialty).
  
  
  RESULTS
  Overall, the images were rated good or very good in most instances and more so for the smartphone (83.1%, mean score 5.7) and tablet (78.2%, mean 5.5) than for a standard computer (70.6%, mean 5.2). Both handheld devices had significantly higher ratings than the computer screen, even after controlling for image type and participants' characteristics. Nearly all experts expressed that they would be comfortable using smartphones (n=25) or tablets (n=26) for image-based teleconsultation.
  
  
  CONCLUSIONS
  This study suggests that handheld devices could be a substitute for computer screens for teleconsultation by physicians working in emergency settings.
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Constance
authors.initials: C
authors.lastname: Boissin
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Lisa
authors.initials: L
authors.lastname: Blom
authors.affiliation: Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Bellville, South Africa.
authors.forename: Lee
authors.initials: L
authors.lastname: Wallis
authors.affiliation: Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.|University of South Africa, Pretoria, South Africa.
authors.forename: Lucie
authors.initials: L
authors.lastname: Laflamme
mesh_terms: D000328:Adult; D000368:Aged; D034201:Computers, Handheld; D003880:Dermatology; D004635:Emergency Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D011446:Prospective Studies; D019114:Remote Consultation / Q000295:instrumentation*; D000068997:Smartphone; D011795:Surveys and Questionnaires; D019112:Teleradiology
keywords: burns; diagnosis; equipment evaluation; imaging; quality assurance