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Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care

BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)–based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinicia...

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Autores principales: Pecina, Jennifer L, Wyatt, Kirk D, Comfere, Nneka I, Bernard, Matthew E, North, Frederick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700409/
https://www.ncbi.nlm.nih.gov/pubmed/29117934
http://dx.doi.org/10.2196/mhealth.8257
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author Pecina, Jennifer L
Wyatt, Kirk D
Comfere, Nneka I
Bernard, Matthew E
North, Frederick
author_facet Pecina, Jennifer L
Wyatt, Kirk D
Comfere, Nneka I
Bernard, Matthew E
North, Frederick
author_sort Pecina, Jennifer L
collection PubMed
description BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)–based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant). RESULTS: During the study period, there were 1139 photo sessions on 1059 unique patients. Of the 1139 sessions, 395 (34.68%) sessions documented dermatologist input in the EHR via dermatology curbside consultation, eConsult, and in-person dermatology consult. Clinicians utilized curbside phone consults preferentially over eConsults for TD. By clinician type, nurse practitioners (NPs) and physician assistants (PAs) were more likely to utilize the PhotoExam for TD as compared with physicians. By specialty type, pediatric clinicians were more likely to utilize the PhotoExam for TD as compared with family medicine and internal medicine clinicians. A total of 108 (9.5%) photo sessions had a biopsy performed of the photographed site. Of these, 46 biopsies (42.6%) were performed by a primary care clinician, and 27 (25.0%) biopsies were interpreted as a malignancy. Of the 27 biopsies that revealed malignant findings, 6 (22%) had a TD consultation before biopsy, and 10 (37%) of these biopsies were obtained by primary care clinicians. CONCLUSIONS: Clinicians primarily used the PhotoExam for non-TD purposes. Nurse practitioners and PAs utilized the app for TD purposes more than physicians. Primary care clinicians requested curbside dermatology consults more frequently than dermatology eConsults.
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spelling pubmed-57004092017-11-29 Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care Pecina, Jennifer L Wyatt, Kirk D Comfere, Nneka I Bernard, Matthew E North, Frederick JMIR Mhealth Uhealth Original Paper BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)–based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant). RESULTS: During the study period, there were 1139 photo sessions on 1059 unique patients. Of the 1139 sessions, 395 (34.68%) sessions documented dermatologist input in the EHR via dermatology curbside consultation, eConsult, and in-person dermatology consult. Clinicians utilized curbside phone consults preferentially over eConsults for TD. By clinician type, nurse practitioners (NPs) and physician assistants (PAs) were more likely to utilize the PhotoExam for TD as compared with physicians. By specialty type, pediatric clinicians were more likely to utilize the PhotoExam for TD as compared with family medicine and internal medicine clinicians. A total of 108 (9.5%) photo sessions had a biopsy performed of the photographed site. Of these, 46 biopsies (42.6%) were performed by a primary care clinician, and 27 (25.0%) biopsies were interpreted as a malignancy. Of the 27 biopsies that revealed malignant findings, 6 (22%) had a TD consultation before biopsy, and 10 (37%) of these biopsies were obtained by primary care clinicians. CONCLUSIONS: Clinicians primarily used the PhotoExam for non-TD purposes. Nurse practitioners and PAs utilized the app for TD purposes more than physicians. Primary care clinicians requested curbside dermatology consults more frequently than dermatology eConsults. JMIR Publications 2017-11-08 /pmc/articles/PMC5700409/ /pubmed/29117934 http://dx.doi.org/10.2196/mhealth.8257 Text en ©Jennifer L Pecina, Kirk D Wyatt, Nneka I Comfere, Matthew E Bernard, Frederick North. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 08.11.2017. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Pecina, Jennifer L
Wyatt, Kirk D
Comfere, Nneka I
Bernard, Matthew E
North, Frederick
Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title_full Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title_fullStr Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title_full_unstemmed Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title_short Uses of Mobile Device Digital Photography of Dermatologic Conditions in Primary Care
title_sort uses of mobile device digital photography of dermatologic conditions in primary care
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5700409/
https://www.ncbi.nlm.nih.gov/pubmed/29117934
http://dx.doi.org/10.2196/mhealth.8257
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