A Smartphone App for Improving Clinical Photography in Emergency Departments: Comparative Study

JMIR Mhealth Uhealth. 2019 Jul 31;7(7):e14531. doi: 10.2196/14531.

Abstract

Background: Digital photography is crucial for electronic medical records (EMRs), particularly for documenting dermatological diseases and traumatic wounds. In modern emergency departments (EDs), digital cameras are commonly used for photography, but the process is time-consuming. The problems of addressing patient privacy issues and that of interruptions and heavy workloads can cause archival errors when uploading photos. However, smartphones are widely available and cheap, so with a suitable app many errors could be mitigated.

Objective: The aim of this study is to design and test a smartphone app to improve the efficiency of clinical photography and improve patient privacy in the ED. The app is connected to the hospital information system to verify patient identification and enable archiving, and the app can automatically delete images after upload to the patient's EMR.

Methods: This study enrolled 48 experienced ED nurses trained in clinical photography. Each nurse was first assigned a digital camera for photography and then a smartphone with the app preinstalled after it was launched. The time taken to upload images to a patient's EMR was then recorded and the efficiency of the digital camera and app groups were compared.

Results: The average time taken to upload images to a patient's EMR for the camera and app groups were 96.3 s (SD 19.3; P<.001) and 26.3 s (SD 4.7; P<.001), respectively.

Conclusions: The app effectively reduced processing time and improved clinical photography efficiency in the ED. Some issues of patient privacy in the camera group were revealed and resolved in the app group.

Keywords: clinical photography; health informatics; patient privacy; smartphone app.

Publication types

  • Comparative Study

MeSH terms

  • Confidentiality
  • Documentation / methods
  • Electronic Health Records / standards
  • Emergency Service, Hospital / statistics & numerical data*
  • Hospital Information Systems / standards
  • Humans
  • Mobile Applications / statistics & numerical data*
  • Mobile Applications / supply & distribution
  • Nurses / statistics & numerical data
  • Photography / instrumentation*
  • Photography / statistics & numerical data
  • Photography / trends
  • Physical Examination / methods
  • Privacy
  • Skin Diseases / diagnosis
  • Skin Diseases / pathology
  • Smartphone / instrumentation*
  • Time Factors
  • Workload
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / pathology