G. M. Taylor1, A. L. Guzman4, J. Wilder6, A. Nakhmani5, R. T. Russell2, J. A. White3, J. H. Willig4 1University Of Alabama at Birmingham,Department Of Surgery,Birmingham, Alabama, USA 2University Of Alabama at Birmingham,Div. Of Pediatric Surgery,Birmingham, Alabama, USA 3University Of Alabama at Birmingham,Div. Of Transplantation,Birmingham, Alabama, USA 4University Of Alabama at Birmingham,Div. Of Infectious Disease,Birmingham, Alabama, USA 5University Of Alabama at Birmingham,Department Of Electrical And Computer Engineering,Birmingham, Alabama, USA 6Datascription,New York, NY, USA
Introduction: Surgical site complications (wound infection, dehiscence, and evisceration) can prolong hospital stays, contribute to readmissions, and necessitate subsequent operations. Early identification of complications improves patient outcomes and reduces healthcare expenditures. In our current practice, providers lack a consistent channel to monitor wound sites and communicate with patients after hospital discharge prior to scheduled follow-up. Phone reports from patients are often insufficient, and photos are difficult to send securely. Our goal was to create a safe and efficient platform for patients to transmit wound site photos and other clinical information to their providers.
Methods: A multidisciplinary team including advanced practitioners, software engineers, surgeons, and infectious disease physicians was convened to leverage health informatics technology and develop a platform for communication with patients after post-operative discharge. In addition, we intend to train image recognition software and machine learning algorithms to independently identify patients with concerning wounds who needed earlier follow-up based on their wound images and supplemental patient questions.
Results: The resulting “Wound Selfie” app for Android and iPhone iOS smartphone platforms provides a secure, HIPAA-compliant tool for providers to evaluate surgical wounds and communicate with patients. At hospital discharge, providers introduce the smartphone app to the patient and help them take an initial wound photo. Patients submit pictures of wound sites regularly for review by the surgical team. In addition, patients answer a series of questions about symptoms related to wound problems and systemic symptoms that help providers provide timely follow-up. Providers can review patients’ wound images in the app or a desktop software interface. Digital analysis of these images will train algorithms that incorporate symptoms and risk factors for wound complications. Ultimately, the app will independently identify patients who need early post-operative intervention.
Conclusions: This app adds a new dimension to patient-provider communication. Surgeons with limited staff and patients who may live far from providers can communicate more efficiently about their postoperative care. This app will serve as a tool to facilitate population health. For example, transplant patients, a regional population with higher rates of wound complications, can instantly send wound-site images and subjective history to their tertiary care center for review. While further study is warranted, we are excited about the potential of new technological and interdisciplinary approaches to improve clinical outcomes for patients.