A study conducted in Jerusalem found that orthopedic consultants were able to successfully identify gross and subtle findings in radiology images through the use of their smartphone.
TEREM Emergency Medical Centers operates five urgent care facilities and consults over 200,000 patients a year, including 10,000 fractures and 30,000 nonfracture injuries. The medical center has round-the-clock computerized radiology, but they wanted to implement a system that would allow their orthopedists to provide consultations without getting on a computer or coming into the medical center. Although they wanted to test smartphone technology, they did not want a patient to be misdiagnosed because the consultants were viewing the images on a small screen.
For their study, 41 sample images were taken from previous consultations. The sample images featured everything from major fractures to minor conditions. The images were sent to the orthopedists to be examined their smartphone.
In all 41 cases, each condition was successfully diagnosed by consultants using their smartphone. To confirm their findings, each image was then reviewed using the medical center’s computerized imaging techniques.
Since the successful study, the TEREM medical center has reviewed an additional 312 images through smartphone technology. As was the case with the study, all images were later confirmed using the center’s computerized imaging. No clinically significant fracture has been missed in any of the 312 cases reviewed by mobile telephone.
The TEREM medical center has also found that their hospital referral rate has dropped significantly since the inception of smartphone consultation technology. They reported a 50% drop in referrals from their clinics to hospitals because remote consultants were often able to provide medical advice to local clinics, which meant that patients could be treated without needing to visit an emergency room. The medical center also reported increased comfort among their clinic physicians because they have greater access to specialized consultation through smartphone technology.
Dr. Silverman comments
I believe this was a great study, and I am pleased that the findings proved to be so successful.
In my line of work, there have been times where I have been asked to provide a consultation using only telephone conversation and limited radiology images. Sometimes the images are sent through email, but I have also reviewed many images using only a smartphone. I have been able to easily review radiographs and select MRI images through both the Android and iPhone platform.
I remember one specific incident where I reviewed a friend’s X-rays on my smartphone while I was on a plane. He had fallen on while on vacation in Hawaii, and I was able to help him plan his care for the rest of the trip.
The prospect of smartphone imaging is exciting, but the finding that revealed a 50% drop in hospital referrals is also crucial. Minor orthopedic injuries are an extremely common reason for emergency room referrals, which can be time consuming and put an extra burden on ER doctors. Redirecting non-emergent problems to a clinic setting will save much needed time and money. I look forward to this seeing this research applied in the United States.
