A Smartphone-based Consultation System for Acute Burns - Methodological Challenges Related to Follow-up of the System

Overview

Journal Glob Health Action

Specialty Public Health

Date 2017 Aug 26

PMID 28838311

Citations 9

Authors

Marie Hasselberg

Lee Wallis

Paul Blessing

Lucie Laflamme

Affiliations

Soon will be listed here.

Abstract

Background: A smartphone-based consultation system for acute burns is currently being implemented in the Western Cape, South Africa. Even though studies indicate that similar systems for burns tend to support valid diagnosis and influence patient management, the evidence is still sparse. There is a need for more in-depth evaluations, not least in resource-constrained settings where mHealth projects are increasing.

Objective: This article describes the consultation system and assessments in relation to its implementation with a special focus on methodological challenges.

Methods: A number of evaluations and assessments have been conducted, are ongoing or planned for in relation to the implementation of the teleconsultation system. Initial assessments showed that size and depth of burns could be assessed at least as well using photographs as at bedside and that the image quality of handheld devices can be used as well as computers. Studies on system usability are currently being done with a mixed-methods approach. A historical cohort design will be applied to assess the potential health impact of the system. Patients with burn injuries where the doctor at point of care has used the app to receive diagnostic support from a burns expert will be considered as exposed and patients with burn injuries where the app has not been used will be considered as non-exposed.

Conclusions: Smartphone-based consultation systems have the potential to strengthen the assessment of burn injury in many settings. However, ethically and methodologically sound evaluations are needed to find the best systems and solutions. This article identifies challenges and suggests potential assessments in relation to the implementation of such a system.

Citing Articles

Utility of Telehealth Platforms Applied to Burns Management: A Systematic Review.

Garcia-Diaz A, Vilardell-Roig L, Novillo-Ortiz D, Gacto-Sanchez P, Pereyra-Rodriguez J, Saigi-Rubio F Int J Environ Res Public Health. 2023; 20(4).

PMID: 36833860 PMC: 9968161. DOI: 10.3390/ijerph20043161.

Telemedicine in Surgical Care in Low- and Middle-Income Countries: A Scoping Review.

Owolabi E, Mac Quene T, Louw J, Davies J, Chu K World J Surg. 2022; 46(8):1855-1869.

PMID: 35428920 PMC: 9012517. DOI: 10.1007/s00268-022-06549-2.

A COVID-19 field hospital in a conference centre - The Cape Town, South Africa experience.

Bulajic B, Ekambaram K, Saunders C, Naidoo V, Wallis L, Amien N Afr J Prim Health Care Fam Med. 2021; 13(1):e1-e9.

PMID: 34931525 PMC: 8678694. DOI: 10.4102/phcfm.v13i1.3140.

Integration of mHealth Information and Communication Technologies Into the Clinical Settings of Hospitals in Sub-Saharan Africa: Qualitative Study.

Ogundaini O, de la Harpe R, McLean N JMIR Mhealth Uhealth. 2021; 9(10):e26358.

PMID: 34643540 PMC: 8552092. DOI: 10.2196/26358.

Patient triage system for supporting the operation of dispatch centres and rescue teams.

Nimmolrat A, Sutham K, Thinnukool O BMC Med Inform Decis Mak. 2021; 21(1):68.

PMID: 33608001 PMC: 7893871. DOI: 10.1186/s12911-021-01440-x.

References

Shokrollahi K, Sayed M, Dickson W, Potokar T . Mobile phones for the assessment of burns: we have the technology. Emerg Med J. 2007; 24(11):753-5. PMC: 2658315. DOI: 10.1136/emj.2007.046730. View

Keane M . A review of the role of telemedicine in the accident and emergency department. J Telemed Telecare. 2009; 15(3):132-4. DOI: 10.1258/jtt.2009.003008. View

Kumar S, Nilsen W, Abernethy A, Atienza A, Patrick K, Pavel M . Mobile health technology evaluation: the mHealth evidence workshop. Am J Prev Med. 2013; 45(2):228-36. PMC: 3803146. DOI: 10.1016/j.amepre.2013.03.017. View

Allorto N, Clarke D . Merits and challenges in the development of a dedicated burn service at a regional hospital in South Africa. Burns. 2014; 41(3):454-61. DOI: 10.1016/j.burns.2014.07.021. View

Palmieri T, Przkora R, Meyer 3rd W, Carrougher G . Measuring burn injury outcomes. Surg Clin North Am. 2014; 94(4):909-16. DOI: 10.1016/j.suc.2014.05.010. View

Atiyeh B, Dibo S, Janom H . Telemedicine and burns: an overview. Ann Burns Fire Disasters. 2015; 27(2):87-93. PMC: 4396801. View

Wallis L, Fleming J, Hasselberg M, Laflamme L, Lundin J . A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care. PLoS One. 2016; 11(2):e0147253. PMC: 4769217. DOI: 10.1371/journal.pone.0147253. View

Lewis E, Thomas C, Wilson M, Mbarika V . Telemedicine in acute-phase injury management: a review of practice and advancements. Telemed J E Health. 2012; 18(6):434-45. PMC: 3399110. DOI: 10.1089/tmj.2011.0199. View

den Hollander D, Mars M . Smart phones make smart referrals: The use of mobile phone technology in burn care - A retrospective case series. Burns. 2016; 43(1):190-194. DOI: 10.1016/j.burns.2016.07.015. View

10.

Mars M, Scott R . WhatsApp in Clinical Practice: A Literature Review. Stud Health Technol Inform. 2016; 231:82-90. View

11.

Boissin C, Fleming J, Wallis L, Hasselberg M, Laflamme L . Can We Trust the Use of Smartphone Cameras in Clinical Practice? Laypeople Assessment of Their Image Quality. Telemed J E Health. 2015; 21(11):887-92. PMC: 4649724. DOI: 10.1089/tmj.2014.0221. View

12.

Boissin C, Laflamme L, Wallis L, FLEMING J, Hasselberg M . Photograph-based diagnosis of burns in patients with dark-skin types: the importance of case and assessor characteristics. Burns. 2015; 41(6):1253-60. DOI: 10.1016/j.burns.2014.12.014. View

13.

Boissin C, Blom L, Wallis L, Laflamme L . Image-based teleconsultation using smartphones or tablets: qualitative assessment of medical experts. Emerg Med J. 2016; 34(2):95-99. PMC: 5384429. DOI: 10.1136/emermed-2015-205258. View

14.

Hasselberg M, Beer N, Blom L, Wallis L, Laflamme L . Image-based medical expert teleconsultation in acute care of injuries. A systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction. PLoS One. 2014; 9(6):e98539. PMC: 4041890. DOI: 10.1371/journal.pone.0098539. View

15.

Gibran N, Wiechman S, Meyer W, Edelman L, Fauerbach J, Gibbons L . Summary of the 2012 ABA Burn Quality Consensus conference. J Burn Care Res. 2013; 34(4):361-85. DOI: 10.1097/BCR.0b013e31828cb249. View

16.

Saffle J, Edelman L, Theurer L, Morris S, Cochran A . Telemedicine evaluation of acute burns is accurate and cost-effective. J Trauma. 2009; 67(2):358-65. DOI: 10.1097/TA.0b013e3181ae9b02. View

17.

Wallace D, Hussain A, Khan N, Wilson Y . A systematic review of the evidence for telemedicine in burn care: with a UK perspective. Burns. 2011; 38(4):465-80. DOI: 10.1016/j.burns.2011.09.024. View

18.

Staley M, Richard R, Warden G, Miller S, Shuster D . Functional outcomes for the patient with burn injuries. J Burn Care Rehabil. 1996; 17(4):362-8. DOI: 10.1097/00004630-199607000-00014. View