Qualitätssteigerung der Abrechnungsprüfung durch Smartphone-basierte Fotodokumentation in der Unfall‑, Hand- und plastischen Chirurgie

Jordan, Martin; Jovic, Sebastian; Gilbert, Fabian; Kunz, Andreas Steven; Ertl, M. Anton; Strobl, Ute; Jakubietz, Rafael G.; Jakubietz, Michael G.; Meffert, Rainer H.; Fuchs, Konrad

doi:10.1007/s00113-020-00866-8

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…Im Jahr 2016 wurde die App um die Möglichkeit erweitert, klinische Fotos z. B. zur Wunddokumentation in das PACS zu überspielen [ 9 ].…”

Section: Hintergrund Und Fragestellungunclassified

Optimizing radiological diagnostic management via mobile devices in trauma surgery

Fuchs,

Kerwagen,

Kunz

et al. 2024

Unfallchirurgie

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Zusammenfassung Hintergrund Ärztliches Personal steht täglich unter hohem zeitlichen Druck. Eine ärztliche Aufgabe ist die Anforderung von radiologischer Diagnostik. Dieser Prozess zeichnet sich durch eine hohe administrative Komplexität und teils enormen zeitlichen Aufwand aus. Maßnahmen, die zugunsten der Versorgung von Patientinnen und Patienten zu einer administrativen Entlastung führen, fehlen bisher. Ziel der Arbeit Prozessoptimierung in der Anforderungsstellung von radiologischer Diagnostik. Als „proof of concept“ wurde in der unfallchirurgischen Abteilung am Universitätsklinikum Würzburg (UKW) die Anforderung radiologischer Diagnostik mittels einer Smartphone- und Tablet-basierten Applikation mit Spracheingabe eingeführt. Material und Methoden In einer prospektiven Studie wurden der zeitliche Effekt und die zeitliche Effizienz der mobilen, ukw.mobile App-basierten Anforderung (UMBA) im Vergleich zur PC-basierten Anforderung (PCBA) zur Anforderung radiologischer Leistungen analysiert. Ermittelt wurden die Zeit von Indikationsstellung bis zur fertigen Anforderung und die benötigte Zeit für die Anforderungserstellung am Endgerät. Aufgrund der Nichtnormalverteilung der Daten wurde ein Mann-Whitney-U-Test durchgeführt. Ergebnisse Die Zeit von der Indikation bis zur fertigen Anforderung konnte durch die mobile Anforderung statistisch signifikant (p < 0,05) reduziert werden (PCBA: Mittelwert ± Standardabweichung [SD] 19,57 ± 33,24 min, Median 3,00 min, Interquartilsabstand [IQR] 1,00–30,00 min vs. UMBA: 9,33 ± 13,94 min, 1,00 min, 0,00–20,00 min). Die Zeit für die Anforderung am Endgerät konnte durch die mobile Anforderung ebenfalls statistisch signifikant reduziert werden (PCBA: Mittelwert ± SD 63,77 ± 37,98 s, Median 51,96 s, IQR 41,68–68,93 s vs. UMBA: 25,21 ± 11,18 s, 20,00 s, 17,27–29,00 s). Diskussion Das mobile, sprachunterstützte Anforderungsverfahren führt zu einer enormen zeitlichen Entlastung im klinischen Alltag und verdeutlicht das Potenzial einer anwenderorientierten, zielgerichteten Digitalisierung im Gesundheitswesen. In Zukunft soll der Prozess durch eine künstliche Intelligenz unterstützt werden. Graphic abstract

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“…Im Jahr 2016 wurde die App um die Möglichkeit erweitert, klinische Fotos z. B. zur Wunddokumentation in das PACS zu überspielen [ 9 ].…”

Section: Hintergrund Und Fragestellungunclassified

Optimizing radiological diagnostic management via mobile devices in trauma surgery

Fuchs,

Kerwagen,

Kunz

et al. 2024

Unfallchirurgie

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“…The implementation process of the MA was carried out in a stepwise and iterative fashion and yields a deep integration into the daily inpatient ward workflows. Apart from access to the EHR, the MA offers also photographic wound documentation, which has already been shown to improve the quality of billing [8]. The technical stack is implemented in three layers (see Fig.…”

Section: Introductionmentioning

confidence: 99%

Usability of a mHealth Solution using Speech Recognition for Point-of-care Diagnostic Management

et al. 2023

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The administrative burden for physicians in the hospital can affect the quality of patient care. The Service Center Medical Informatics (SMI) of the University Hospital Würzburg developed and implemented the smartphone-based mobile application (MA) ukw.mobile1 that uses speech recognition for the point-of-care ordering of radiological examinations. The aim of this study was to examine the usability of the MA workflow for the point-of-care ordering of radiological examinations. All physicians at the Department of Trauma and Plastic Surgery at the University Hospital Würzburg, Germany, were asked to participate in a survey including the short version of the User Experience Questionnaire (UEQ-S) and the Unified Theory of Acceptance and Use of Technology (UTAUT). For the analysis of the different domains of user experience (overall attractiveness, pragmatic quality and hedonic quality), we used a two-sided dependent sample t-test. For the determinants of the acceptance model, we employed regression analysis. Twenty-one of 30 physicians (mean age 34 ± 8 years, 62% male) completed the questionnaire. Compared to the conventional desktop application (DA) workflow, the new MA workflow showed superior overall attractiveness (mean difference 2.15 ± 1.33), pragmatic quality (mean difference 1.90 ± 1.16), and hedonic quality (mean difference 2.41 ± 1.62; all p < .001). The user acceptance measured by the UTAUT (mean 4.49 ± 0.41; min. 1, max. 5) was also high. Performance expectancy (beta = 0.57, p = .02) and effort expectancy (beta = 0.36, p = .04) were identified as predictors of acceptance, the full predictive model explained 65.4% of its variance. Point-of-care mHealth solutions using innovative technology such as speech-recognition seem to address the users’ needs and to offer higher usability in comparison to conventional technology. Implementation of user-centered mHealth innovations might therefore help to facilitate physicians’ daily work.

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Improving Medical Photography in a Level 1 Trauma Center by Implementing a Specialized Smartphone-Based App in Comparison to the Usage of Digital Cameras: Prospective Panel Study

El Barbari,

Fikuart,

Beisemann

et al. 2024

JMIR Form Res

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Background Medical photography plays a pivotal role in modern health care, serving multiple purposes ranging from patient care to medical documentation and education. Specifically, it aids in wound management, surgical planning, and medical training. While digital cameras have traditionally been used, smartphones equipped with specialized apps present an intriguing alternative. Smartphones offer several advantages, including increased usability and efficiency and the capability to uphold medicolegal standards more effectively and consistently. Objective This study aims to assess whether implementing a specialized smartphone app could lead to more frequent and efficient use of medical photography. Methods We carried out this study as a comprehensive single-center panel investigation at a level 1 trauma center, encompassing various settings including the emergency department, operating theaters, and surgical wards, over a 6-month period from June to November 2020. Using weekly questionnaires, health care providers were asked about their experiences and preferences with using both digital cameras and smartphones equipped with a specialized medical photography app. Parameters such as the frequency of use, time taken for image upload, and general usability were assessed. Results A total of 65 questionnaires were assessed for digital camera use and 68 for smartphone use. Usage increased significantly by 5.4 (SD 1.9) times per week (95% CI 1.7-9.2; P=.005) when the smartphone was used. The time it took to upload pictures to the clinical picture and archiving system was significantly shorter for the app (mean 1.8, SD 1.2 min) than for the camera (mean 14.9, SD 24.0 h; P<.001). Smartphone usage also outperformed the digital camera in terms of technical failure (4.4% vs 9.7%; P=.04) and for the technical process of archiving (P<.001) pictures to the picture archiving and communication system (PACS) and display images (P<.001) from it. No difference was found in regard to the photographer’s intent (P=.31) or reasoning (P=.94) behind the pictures. Additionally, the study highlighted that potential concerns regarding data security and patient confidentiality were also better addressed through the smartphone app, given its encryption capabilities and password protection. Conclusions Specialized smartphone apps provide a secure, rapid, and user-friendly platform for medical photography, showing significant advantages over traditional digital cameras. This study supports the notion that these apps not only have the potential to improve patient care, particularly in the realm of wound management, but also offer substantial medicolegal and economic benefits. Future research should focus on additional aspects such as patient comfort and preference, image resolution, and the quality of photographs, as well as seek to corroborate these findings through a larger sample size.

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Qualitätssteigerung der Abrechnungsprüfung durch Smartphone-basierte Fotodokumentation in der Unfall‑, Hand- und plastischen Chirurgie

Cited by 3 publications

References 9 publications

Optimizing radiological diagnostic management via mobile devices in trauma surgery

Optimizing radiological diagnostic management via mobile devices in trauma surgery

Usability of a mHealth Solution using Speech Recognition for Point-of-care Diagnostic Management

Improving Medical Photography in a Level 1 Trauma Center by Implementing a Specialized Smartphone-Based App in Comparison to the Usage of Digital Cameras: Prospective Panel Study

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