A Novel, Mobile-Phone, EMR-Based Application to Improve Workflow for Standardized Clinical Photography.

Goals/Purpose: Standardized medical photography of the face is a vital part of clinical evaluation prior to and after any surgical or non-surgical intervention is performed. Although guidelines exist for standardized clinical photography of the face, few plastic surgery practices have access to the resources, staff or equipment needed to meet these guidelines let alone transfer the photo into the medical record easily. Inspired by mobile check deposit and a novel solution to this critical need was developed.

Methods/Technique: A team consisting of an academic craniofacial plastic surgeon and the Health Information Technology ( IT) product development group at our Institution developed and implemented the pilot application. The application launches directly from patients’ chart in the mobile version of the EMR, in this case, EPIC Haiku ( Verona, WI) . Standard views of the face ( 90 degree , oblique left and right, front and basal view) were built into digital templates. The user can select which views they wish to capture. Once selected, the frames overlay the patients’ face on the screen and are red by default. The face frames turns green once the facial features fall into standardized views, then prompting the user to capture the image. The background is then digitally subtracted to blue (hex code 0x0089B6) and available in the patients’ chart. Before upload, the user has the ability to retake a photo and upload a composite to the EMR. The photo is not stored on the users phone. See figure for demonstration of work flow.

Results/Complications: The pilot application has been in use at our Institution since Jan 2022 and expanded to 17 test users across dermatology, ENT and plastic surgery. A mix of physicians, PA’s, NP’s a nurses all routinely use the app from their mobile phones in the outpatient setting to capture clinical images of the face.

Conclusion: This technology integrated into the EMR could save both time and expense for clinicians seeking to take consistent clinical images, particularly of the same patient over time. Future steps include continued refinement of current facial image capture functionality and addition of other anatomic areas.