Teleconsultation Using Mobile Phones for Diagnosis and Acute Care of Burn Injuries Among Emergency Physicians: Mixed-Methods Study

Overview

Journal JMIR Mhealth Uhealth

Specialties Biomedical Engineering
Medical Informatics

Date 2018 Oct 21

PMID 30341047

Citations 10

Authors

Anders Klingberg

Lee Alan Wallis

Marie Hasselberg

Po-Yin Yen

Sara Caroline Fritzell

Affiliations

Soon will be listed here.

Abstract

Background: The referral process in acute care remains challenging in many areas including burn care. Mobile phone apps designed explicitly for medical referrals and consultations could streamline the referral process by using structured templates and integrating features specific to different specialties. However, as these apps are competing with commercial chat services, usability becomes a crucial factor for successful uptake.

Objective: The aim of this study was to assess the usability of a mobile phone app for remote consultations and referrals of burn injuries.

Methods: A total of 24 emergency doctors and 4 burns consultants were recruited for the study. A mixed-methods approach was used including a usability questionnaire and a think-aloud interview. Think-aloud sessions were video-recorded, and content analysis was undertaken with predefined codes relating to the following 3 themes: ease of use, usefulness of content, and technology-induced errors.

Results: The users perceived the app to be easy to use and useful, but some problems were identified. Issues relating to usability were associated with navigation, such as scrolling and zooming. Users also had problems in understanding the meaning of some icons and terminologies. Sometimes, some users felt limited by predefined options, and they wanted to be able to freely express their clinical findings.

Conclusions: We found that users faced problems mainly with navigation when the app did not work in the same way as the other apps that were frequently used. Our study also resonates with previous findings that when using standardized templates, the systems should also allow the user to express their clinical findings in their own words.

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References

Reiband H, Lundin K, Alsbjorn B, Sorensen A, Rasmussen L . Optimization of burn referrals. Burns. 2013; 40(3):397-401. DOI: 10.1016/j.burns.2013.08.001. View

Doud A, Swanson J, Ladd M, Neff L, Carter J, Holmes J . Referral patterns in pediatric burn patients. Am Surg. 2014; 80(9):836-40. View

Paik A, Granick M, Scott S . Plastic surgery telehealth consultation expedites Emergency Department treatment. J Telemed Telecare. 2016; 23(2):321-327. DOI: 10.1177/1357633X16639459. View

Thomas K . Wanted: a WhatsApp alternative for clinicians. BMJ. 2018; 360:k622. DOI: 10.1136/bmj.k622. View

Thom D . Appraising current methods for preclinical calculation of burn size - A pre-hospital perspective. Burns. 2016; 43(1):127-136. DOI: 10.1016/j.burns.2016.07.003. View

Cinaglia P, Tradigo G, Guzzi P, Veltri P . Design and Implementation of a Telecardiology System for Mobile Devices. Interdiscip Sci. 2015; 7(3):266-74. DOI: 10.1007/s12539-015-0267-8. View

Martinez R, Rogers A, Numanoglu A, Rode H . The value of WhatsApp communication in paediatric burn care. Burns. 2018; 44(4):947-955. DOI: 10.1016/j.burns.2017.11.005. View

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

Giordano V, Koch H, Mendes C, Bergamin A, Souza F, do Amaral N . WhatsApp Messenger is useful and reproducible in the assessment of tibial plateau fractures: inter- and intra-observer agreement study. Int J Med Inform. 2014; 84(2):141-8. DOI: 10.1016/j.ijmedinf.2014.11.002. View

10.

Tan G, Cohen H, Taylor F, Gabbay J . Referral of patients to an anticoagulant clinic: implications for better management. Qual Health Care. 1993; 2(2):96-9. PMC: 1055092. DOI: 10.1136/qshc.2.2.96. View

11.

Combi C, Pozzani G, Pozzi G . Telemedicine for Developing Countries. A Survey and Some Design Issues. Appl Clin Inform. 2016; 7(4):1025-1050. PMC: 5228142. DOI: 10.4338/ACI-2016-06-R-0089. View

12.

van Niekerk A, Laubscher R, Laflamme L . Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001-2004: an observational register based study. BMC Public Health. 2009; 9:374. PMC: 2765964. DOI: 10.1186/1471-2458-9-374. View

13.

Klingberg A, Wallis L, Rode H, Stenberg T, Laflamme L, Hasselberg M . Assessing guidelines for burn referrals in a resource-constrained setting: Demographic and clinical factors associated with inter-facility transfer. Burns. 2017; 43(5):1070-1077. DOI: 10.1016/j.burns.2017.01.035. View

14.

Rybarczyk M, Schafer J, Elm C, Sarvepalli S, Vaswani P, Balhara K . A systematic review of burn injuries in low- and middle-income countries: Epidemiology in the WHO-defined African Region. Afr J Emerg Med. 2018; 7(1):30-37. PMC: 6234151. DOI: 10.1016/j.afjem.2017.01.006. View

15.

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

16.

Eksert S, Asik M, Akay S, Keklikci K, Aydin F, Coban M . Efficiency of instant messaging applications in coordination of emergency calls for combat injuries: A pilot study. Ulus Travma Acil Cerrahi Derg. 2017; 23(3):207-211. DOI: 10.5505/tjtes.2016.37897. View

17.

Jaspers M, Steen T, van den Bos C, Geenen M . The think aloud method: a guide to user interface design. Int J Med Inform. 2004; 73(11-12):781-95. DOI: 10.1016/j.ijmedinf.2004.08.003. View

18.

Borve A, Gyllencreutz J, Terstappen K, Johansson Backman E, Aldenbratt A, Danielsson M . Smartphone teledermoscopy referrals: a novel process for improved triage of skin cancer patients. Acta Derm Venereol. 2014; 95(2):186-90. DOI: 10.2340/00015555-1906. View

19.

Cillessen F, de Vries Robbe P, Biermans M . A hospital-wide transition from paper to digital problem-oriented clinical notes. A descriptive history and cross-sectional survey of use, usability, and satisfaction. Appl Clin Inform. 2017; 8(2):502-514. PMC: 6241734. DOI: 10.4338/ACI-2016-08-RA-0137. View

20.

Parvizi D, Kamolz L, Giretzlehner M, Haller H, Trop M, Selig H . The potential impact of wrong TBSA estimations on fluid resuscitation in patients suffering from burns: things to keep in mind. Burns. 2013; 40(2):241-5. DOI: 10.1016/j.burns.2013.06.019. View