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Personal Wireless Device Use for Wound Care Consultation: A Review of Safety, Clinical Benefits and Guidelines

Published on: May 16, 2014
Project Number: RC0554-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Report in Brief

Context
Wireless technologies such as smart phones and tablets are being used increasingly by clinicians for a variety of purposes. In dermatology, the use of wireless devices has revolutionized the process of documenting wounds, making consultations with specialists easier and less time-consuming. Physicians providing wound care use the technology to record patients’ medical images and other data and then transmit them to specialists over mobile phone networks.

Technology
Personal wireless devices such as mobile phones have built-in cameras and data transfer capabilities, which make them useful as telemedicine technology. However, slow data upload speeds in remote areas may result in unacceptably long image upload times. As well, the images of wounds taken with mobile phone cameras may be of variable quality and therefore may impact the assessment and subsequent management plan for wound care. There are also legal implications, security challenges, and confidentiality issues to consider.

Issue
Personal wireless devices can enhance wound care management; however, there are potential risks that should be considered. A review of the evidence on the clinical benefits and safety of personal wireless devices for wound care consultation, and of the relevant guidelines, will help inform decisions about their use.

Methods
A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).

Results
The literature search identified 575 citations, 30 of which were deemed potentially relevant, with no additional articles identified from other sources. After full-text screening, 24 articles were excluded, and 6 met the criteria for inclusion in this review ― 1 randomized controlled study and 5 non-randomized studies.

Key Messages

  • Wound care diagnoses and management plans resulting from remote consultation using personal wireless devices appear to be similar to those resulting from face-to-face consultation (based on small studies).
  • Insufficient evidence was found on which to make conclusions on clinical efficacy or harms.
  • No guidelines on the use of personal wireless devices for wound care consultation were found.

Question

  1. What are the clinical benefits and safety issues associated with personal wireless devices for wound care consultation?
  2. What are the clinical benefits and safety issues of sending digital images taken with personal wireless devices by email?
  3. What are the guidelines associated with the use of personal wireless devices for wound care consultation?

Key Message

Non-randomized studies suggest there is agreement in diagnoses and management plans for wound care between face-to-face consultation and remote consultation using smartphone images sent to the specialist’s smartphone or to a dedicated account via e-mail. The extent of agreement varies with the type of skin condition. Studies were relatively small (fewer than 100 patients). Hence, results need to be interpreted with caution. Though in most studies the extent of agreement for diagnosis and management of wound care was reported, wound care healing rates or harms were not reported. Therefore, definite conclusions on clinical efficacy or harms are not possible. No evidence based guidelines on the use of mobile phones were identified.

Tags

mobile phone, cell phone, wounds, cellular phone, lacerations, telemedicine, wound healing, telehealth, wounds and injuries, iPhone, Smart phone, Cell phones, mobile phones, teledermatology