Get the Picture: A Pilot Feasibility Study of Telemedical Wound Assessment Using a Mobile Phone in Cardiology Patients.
BACKGROUND
Postprocedural complications after elective cardiac interventions include hematomas and infections. Telemedical wound assessment using mobile phones with integrated cameras may improve quality of care and help reduce costs.


OBJECTIVE
We aimed to study the feasibility of telemedical wound assessment using a mobile phone. The primary aim was the number of patients who were able to upload their pictures. Secondary aims were image interpretability, agreement between nurse practitioners, and patient evaluation of the intervention.


METHODS
This is a prospective study of all consecutive patients who underwent an elective cardiac intervention. Patients were instructed to photograph their wound or puncture site after hospital discharge and upload the pictures to a secure email address 6 days after hospital discharge. Received photos were assessed by 2 nurse practitioners. The intervention was evaluated using a peer-reviewed questionnaire and photo assessment scheme.


RESULTS
In total, 46 eligible patients were included in the study, with 5 screen failures (eg, clinical stay ≥ 6 days) and 1 patient lost to follow-up. Thirty-three of 40 patients (83%) were able to upload their pictures. Smartphone users were more successful in uploading their pictures compared with feature phone users (93% vs 55%, P < .01). Eighty-eight percent of the clinical pictures were interpretable. The interobserver variability had an agreement between 93% and 97%.


CONCLUSIONS
Patients are able to take and upload the mobile clinical photos to the secure email address, and the vast majority was interpretable. Smartphone users were more successful than feature phone users in uploading their pictures. The interobserver variability was good.
John de Heide, MANP Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. C.J. Vroegh, MANP Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. T. Szili Torok, MD, PhD Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. R.J.J. Gobbens, PhD Inholland University of Applied Sciences, Amsterdam, The Netherlands. F. Zijlstra, MD, PhD Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. M. Takens-Lameijer, MANP Department of Cardiology, University Medical Center Utrecht, The Netherlands. M.J. Lenzen, PhD Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. S.C. Yap, MD, PhD Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands. W.J.M. Scholte op Reimer, PhD Amsterdam University of Applied Sciences, The Netherlands.
John
J
de Heide
C J
CJ
Vroegh
T
T
Szili Torok
R J J
RJ
Gobbens
F
F
Zijlstra
M
M
Takens-Lameijer
M J
MJ
Lenzen
S C
SC
Yap
W J M
WJ
Scholte Op Reimer
D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000601:surgery*; D040421:Cell Phone; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D000072836:Surgical Wound / Q000473:pathology*; D017216:Telemedicine