Telemedical Wound Care Using a New Generation of Mobile Telephones

Abstract

Background: Leg ulcers are an important cost factor in health care systems. It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs. In this study, we evaluated the feasibility of telemedical wound care using a new generation of mobile telephones with integrated cameras.Observations: Three physicians separately evaluated 61 leg ulcers for the following 9 variables: epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. One physician performed the face-to-face consultation (gold standard), and 2 others performed the remote evaluation. The image was obtained with the mobile telephone and immediately sent via e-mail. To measure the agreement of the evaluation among the 3 physicians, we used Cohen statistics. Overall, the agreement between the remote and face-to-face evaluations was very good, with values of up to 0.94 The image quality was judged to be good in 36 cases (59%) and very good in 12 (20%). The participants felt comfortable making a diagnosis based on the pictures in 50 cases (82%). Conclusion:Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation.

Simple Telemedicine for Developing Regions: Camera Phones and Paper-Based Microfluidic Devices for Real-Time, Off-Site Diagnosis

“…Two recent studies showed that camera phones could be used to acquire and transmit images of wounds and rashes to off-site locations for diagnosis. 3,4 The cellular communications industry is, and will continue to become, a global resource that can be leveraged for detecting disease.…”

“…[3][4][5] This latter part of the system should rely on methods of transmitting and receiving information that already exist, and that do not require additional infrastructure. A system for clinical analysis should thus be: (i) inexpensive; 6 (ii) operable with little or no requirement for electricity; 7 (iii) adaptable to a number of types of assays in a range of conditions; (iv) simple enough to be used by non-technical personnel; 2 (v) rapid; 2 (vi) accurate; 2 and (vii) quantitative.…”

Mobile Device for Disease Diagnosis and Data Tracking in Resource-Limited Settings

“…For example, recent studies have demonstrated how cell phones can improve patient and public health (42)(43)(44)(45), but typically use only offthe-shelf technologies with limited technical features (primarily text messaging). It is likely that mobile health devices with increased functionalities can deliver a highly expanded range of healthcare services right to patients, no matter how remote their location.…”

Effectiveness of Telemedicine for Distant Wound Care Advice towards Patient Outcomes: Systematic Review and Meta-Analysis

“…Hofmann-Wellenhof, et al [53] Outcome: Comparing accuracy of assessment 46 Ratliff, et al [54] Outcome: Evaluate cost saving and quality of care 47 Halstead, et al [55] Outcomes: Comparing accuracy between tele and in-person assessment 48 Saffle, et al [56] Outcome: Improve resource utilization 49 Clegg, et al [57] Outcome: Cost saving 50 Rasmussen, et al [58] Outcome: Comparing accuracy between tele and in-person assessment 51 Braun, et al [59] Outcome: Feasibility 52…”

“…Johnson-Mekota, et al [64] Outcome: Patients' and providers' satisfaction 58 Chan, et al [65] Outcome: Using scoring scale 59 Hill, et al 2009 [66] Outcome: Comparing accuracy of assessment 60 Salmhofer, et al [67] Outcome: Comparing accuracy of assessment • Page 4 of 9 •…”