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A Picture is Worth 1,000 Words Commentary 

A Picture is Worth 1,000 Words

Many patient conditions are difficult to describe accurately but can easily be captured by a digital photo. While most hospital EMRs will accept photo files, the process can be very cumbersome. A digital camera has to be found, the picture taken, then uploaded to the hospital EMR system through a PC. This not only takes time and multiple devices but potentially leaves images on unsecured devices.

In a much more efficient approach, HarmoniMD, an EMR developed by EHRI Inc., uses tablets to access patient charts and can take photos directly into the patient chart without storing an image on an unsecured medium. This system also displays all of the prior photos for the patient, which makes taking a series of photos to represent the healing process much easier and more reliable.

Being able to view photos of patient conditions on the same device that contains the patient chart is also very helpful to physicians, nurses and patients alike. As the healing process progresses, documenting the progress on a daily basis will give the clinical team a much better view than having to read through many paragraphs of text. Photos can also alert the team to setbacks or deterioration much faster than having to interpret nurse or physician notes.

Explaining to patients how their care is progressing can be made much easier if they are able to see the progress visually. This is especially true for injuries, wounds and surgeries that the patient can’t see as in the case of wounds on the back or buttocks. Allowing patients to view their condition and progress can also be useful and is generally reassuring.

Tablets have excellent auto focus cameras and can take photos in low light conditions that might otherwise be challenging. Most tablets will focus as close as 2-3 inches from the subject and once the image is captured it can be expanded to show even more detail than would be available to the naked eye. In this respect, they take the place of a magnifying glass to allow finer details to be viewed.

When an image is captured, it should be reviewed before saving to the patient chart to make sure that it is in good focus and displays the condition clearly. Placing a disposable ruler next to the area to be captured will make comparison easier and more accurate. Lighting can also make a difference in the quality of the image and a series taken over a number of days or weeks is best done with consistent lighting.

Sonoma West Medical Center in Sebastopol, California uses bedside photos to track wound care and post-surgical healing by taking photos every time dressings are replaced, both before and after the process is complete. This documents not only the patient’s condition but also the treatment that was done. The 7 inch Lenovo tablets that nurses carry is ideal for this process and obviate the need for cameras and uploading of images.



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