Patient-generated Digital Images after Pediatric Ambulatory Surgery

Journal: Applied Clinical Informatics
ISSN: 1869-0327
Issue: Vol. 7: Issue 3 2016
Pages: 646-652

Patient-generated Digital Images after Pediatric Ambulatory Surgery

Case Report

M. W. Miller (1), R. K. Ross (1), C. Voight (1), H. Brouwer (1), D. J. Karavite (2), J. S. Gerber (1, 3, 4), R. W. Grundmeier (3, 2), S. E. Coffin (1, 3, 4)

(1) Division of Infectious Disease, Children’s Hospital of Philadelphia, Philadelphia Pennsylvania; (2) Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; (3) Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; (4) Center of Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania


Patient Records, surgery, workflow, Ambulatory care information systems, clinical images


Objective: To describe the use of digital images captured by parents or guardians and sent to clinicians for assessment of wounds after pediatric ambulatory surgery.

Methods: Subjects with digital images of post-operative wounds were identified as part of an on-going cohort study of infections after ambulatory surgery within a large pediatric healthcare system. We performed a structured review of the electronic health record (EHR) to determine how digital images were documented in the EHR and used in clinical care.

Results: We identified 166 patients whose parent or guardian reported sending a digital image of the wound to the clinician after surgery. A corresponding digital image was located in the EHR in only 121 of these encounters. A change in clinical management was documented in 20% of these encounters, including referral for in-person evaluation of the wound and antibiotic prescription.

Conclusion: Clinical teams have developed ad hoc workflows to use digital images to evaluate post-operative pediatric surgical patients. Because the use of digital images to support follow-up care after ambulatory surgery is likely to increase, it is important that high-quality images are captured and documented appropriately in the EHR to ensure privacy, security, and a high-level of care.

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