Pre-implementation phase: podiatry trial of store & forward technology

Sarah Jensen1

1 Metro North Hospital & Health Service CISS, 490 Hamilton Road Chermside, Queensland, 4032, sarah.jensen2@health.qld.gov.au

 

Background

The Queensland Hospital and Health Service (HHS) podiatry network is a small, mobile profession, delivering care in a variety of clinical settings. Clinical photography is recognised as a standard tool utilised by the profession predominately in the area of wound management. As HHSs become more technologically advanced, the current inefficient process of clinical photography is limiting collaborative care and underutilising this effective clinical tool. Store and forward telemedicine is a recognised form of asynchronous telehealth that can facilitate the access and sharing of clinical images. The pre-implementation phase of this project aims to establish current uses of technology and clinical photography practices amongst Queensland HHS podiatrists, with the intention of investigating the applicability of trialling store and forward technology in clinical photography, using a Smartphone and app.

Methods

All Queensland HHS podiatrists were invited to participate in a scoping survey regarding the objectives of this project.

Results

From the current 66 HHS podiatrists in Queensland, 54 responded to the survey with 45 completing it in its entirety. The survey drew responses from all HHSs excluding Wide Bay, Mackay and Children’s Health Queensland. Of respondents who treat foot ulceration, 95% capture clinical images. HHS supplied digital cameras were the current choice of technology for clinical photography with 82% usage. Interestingly, 38% of respondents have used a personal device (mobile phone, tablet, digital device) to take clinical photographs. The most commonly reported clinical reasons for taking clinical images was to discuss a clinical presentation with a colleague (64%), routine practice (53%) and patient engagement (53%). Of all clinical images taken by respondents in their current practice, 77% were made available to be accessed by other practitioners involved in the patient’s care. However 48.5% of this shared access is limited to a patient’s paper-based chart. Time restraints (58%) were recognised as the main personal barrier to taking clinical images with a third of respondents highlighting a current inefficient process to capturing, storing and sharing photographs.

Discussion

The use of clinical photography within HHS podiatry is a valuable tool used in the provision of patient care. The cohort has demonstrated an already established practice of taking clinical images and a willingness to integrate portable technology into their clinical practice with the expectation of improving collaborative care and clinical photography processes. The varied scope of practice and clinical settings within HHS podiatry will test the capability of store and forward technology using a Smartphone device and will provide clinical applications to a broad range of other services wanting to adopt this technology. Although there are potential risks to privacy breaches, this can be mitigated through clear protocols and consultation with clinicians. It is hypothesised that a successful trial of a Smartphone and app device utilising store and forward technology will result in a self-sustainable model. In addition, the hypothetical scenario of future incentive payments to HHSs for the utilisation of store and forward technology will be invaluable in establishing this application into clinical practice.