Tolins Molly L, Hippe Daniel S, Morse Sophie C, Evans Heather L, Lober William B, Vrablik Marie C
Department of Emergency Medicine, The Permanente Medical Group, Oakland, California.
Department of Radiology, University of Washington, Seattle, Washington.
J Emerg Med. 2019 Nov;57(5):629-636. doi: 10.1016/j.jemermed.2019.07.017. Epub 2019 Oct 5.
Many patients presenting to emergency departments (EDs) do not have primary care and risk being lost to follow-up. Technology has been used successfully in surgical populations for wound care follow-up yet this is not well studied in ED populations.
We aimed to conduct a pilot study demonstrating "smartphone" application-based follow-up after wound care in the ED.
We enrolled participants in 2 urban EDs using a smartphone application called Mobile Post-Operative Wound Evaluator (mPOWEr) and defined participation as photographic submission at any time during the study period. We collected demographic data, frequency of use of mPOWEr, number of photographs uploaded, and timing of uploads.
We approached patients for study enrollment, and 67 patients (28%) were not enrolled because they had no access to a smartphone. Seventy-one patients (30%) declined to enroll, leaving 100 (42%) successfully enrolled. Smartphone ownership was more common among patients <40 years of age (81% vs. 64%, p = 0.004), more common among white patients than nonwhite patients (75% vs. 15%, p = 0.046), more common among patients approached at the university medical center than the trauma center (84% vs. 66%, p = 0.003), and among patients with commercial or other insurance than those with Medicare or Medicaid (92% vs. 54%, p < 0.001). Of those enrolled, 58% submitted a photograph.
Patients presenting for wound care to the ED will participate in smartphone-based app communication for wound care follow-up and are satisfied with this option. Disparities in smartphone access must be considered when using this follow-up method.
许多前往急诊科(ED)就诊的患者没有初级保健服务,存在失访风险。技术已成功应用于外科患者的伤口护理随访,但在急诊科患者中对此研究较少。
我们旨在开展一项试点研究,展示急诊科伤口护理后基于“智能手机”应用程序的随访情况。
我们在两家城市急诊科招募参与者,使用一款名为“移动术后伤口评估器”(mPOWEr)的智能手机应用程序,并将在研究期间任何时间提交照片定义为参与。我们收集了人口统计学数据、mPOWEr的使用频率、上传照片的数量以及上传时间。
我们邀请患者参与研究,67名患者(28%)未被纳入,原因是他们无法使用智能手机。71名患者(30%)拒绝参与,100名患者(42%)成功纳入。智能手机拥有情况在40岁以下患者中更为常见(81%对64%,p = 0.004),在白人患者中比非白人患者更常见(75%对15%,p = 0.046),在大学医学中心就诊的患者中比创伤中心就诊的患者更常见(84%对66%,p = 0.003),在拥有商业保险或其他保险的患者中比拥有医疗保险或医疗补助的患者更常见(92%对54%,p < 0.001)。在纳入的患者中,58%提交了照片。
因伤口护理前往急诊科的患者将参与基于智能手机应用程序的伤口护理随访沟通,并对该选择感到满意。使用这种随访方法时必须考虑智能手机获取方面的差异。