ewma 2013 - ep428 - utilization of store and forward digital technology for the assessment of acute...
DESCRIPTION
UTILIZATION OF STORE AND FORWARD DIGITAL TECHNOLOGY FOR THE ASSESSMENT OF ACUTE WOUND MANAGEMENT Mark Granick1, Ian Hoppe1, Sandra Scott1 1New Jersey Medical School-UMDNJ (Newark, United States).TRANSCRIPT
Ian Hoppe, MDMark Granick, MD, FACSDepartment of Surgery (Plastic)New Jersey Medical SchoolNewark, New Jersey, USA
Plastic Surgeons in the Emergency Department Top 5 consultant
service Hand injuries Acute wounds Facial fractures
Hardest service to get
Resident complaints
Study of PS Consultations Inner city university hospital ED Level 1 Trauma Center 4 month study period Collect digital images and basic data
on all ED consults, no Trauma consults
Analyzed by store and forward technology
Findings
79 consults 66 male, 13 female, 2-71 years old, mean 35 Hand injuries
14 bony 25 soft tissue 15 complex
Head and Neck injuries 4 bony 9 soft tissue 3 complex
Other injuries – all soft tissue 1 leg 2 trunk 5 upper extremity
Findings
Head and Neck injuries 4 bony 9 soft tissue 3 complex
Other injuries – all soft tissue 1 leg 2 trunk 5 upper extremity
Spectrum of Injuries
Hand - bonyHand – soft tissueHand -complexFacial - bony
Facial- soft tissueFacial - complex
Assessment
All cases required specialist consultation
All cases appropriate for Plastic Surgery
All cases educational for the residents
What happened to all the other cases?Incorrect ulnar gutter splint Ineffective thumb spica
Sent to Plastic Surgery Clinic374 patients seen in clinic with 44 no shows154 of the 374 seen were ED referrals
QA Analysis
All patients referred were appropriate
Numerous patients missed
First therapeutic intervention is critical
Better to call than to treat a late complication
Recommendations
Digital imaging provides sufficient information to make an accurate assessment
Store and Forward analysis can make ED consultation more efficient and more effective
Digital image review is an appropriate QA tool Develop telemedical/telehealth system with
specialists to insure proper initial care Patient privacy Medical Licensing Malpractice International and regional legal boundaries www.iConsultMD.com
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