Physicians use photos from patients' cellphones to deliver 'mobile health'

By Leslie Tamura
Washington Post Staff Writer
Tuesday, August 31, 2010

The night before his fourth birthday, Rohan Giare of Rockville rolled off his bed and gashed the bridge of his nose. Rohan's dad, not knowing whether he should focus on getting the bleeding to stop or go immediately to the emergency room, snapped pictures of the cut with his BlackBerry and sent them to his doctor friend, Neal Sikka.

"I just gave [Sikka] a ring," Vishal Giare said, "and got initial input on how serious it might be."

Sikka, an emergency physician at George Washington University, looked at the photos and recommended a trip to the hospital.

Sikka has gotten comfortable using his camera phone to make informal diagnoses for friends and family since he became a doctor in 1999. And as he embraced cellphone culture, Sikka said, he wondered if he could confidently and consistently make diagnoses if regular patients sent him injury snapshots.

In May, Sikka began a six-month study examining how accurately emergency doctors and physician assistants at GWU Hospital could diagnose wounds from patient-generated cellphone images. According to Sikka, it is the largest "mobile health" study looking at acute wound care.

"Mobile health" does not mean a clinic on wheels. It is an emerging field within telemedicine that comprises all aspects of care generated from or available on a portable mobile device such as a cellphone.

Doctors already use traditional forms of telemedicine -- teleconferencing and videoconferencing -- but Sikka said "mHealth" goes further, eliminating the need for scheduling conference rooms and reserving equipment.

MHealth could especially benefit patients living in isolated areas and those who don't want to spend the time, money and energy waiting for evaluation of a superficial injury, Sikka added.

"For emergency medicine," Sikka said, mHealth "allows us to reach out into the community and provide a service that crosses that whole issue of time and space."

In the new study, researchers recruit people who have arrived at the hospital with cuts, skin infections, rashes and other flesh wounds.

Patients use their own camera phones to document their injuries. After filling out a questionnaire about their medical history and symptoms, they send the images to a secure e-mail account. All images are downloaded and stored on a secure hard drive.

"We'll look at their picture along with the questionnaire and make a diagnosis," Sikka said. Researchers use a PC to zoom in and focus on specific parts of the photo. Then the doctor will see the patient to see if the cellphone diagnosis was accurate.

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