EMR Hack – Wound Tracking with a SmartPhone

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Recently, while on-site during an EHR  implementation a physician asked me if I knew of an easy way to import wound photos into patient charts. I asked him if he used DropBox and he said that he did. I walked him through the three step process and he was sold.

Anyone not currently a DropBox user will have to go to the site, sign up and install the application on their desktop and mobile devices (PC, MAC, iPhone, Droid, iPad, etc.). DropBox will create a folder on the desktop PC that may used to import files into an EHR application. Even the most rudimentary of EHR systems should allow users to import JPEG and .pdf files. Once this is done importing wound tracking photos is as easy as 1, 2, 3.

1. Use a SmartPhone to take a photo of the wound and choose the DropBox icon.


2. Upload the photo to DropBox.

3. Access the EHR from a desktop computer, navigate to the DropBox folder and import the photo into the appropriate patient’s chart.



Depending on the functionality in the EHR program, imported photos may have comments added and/or routed to clinical staff for review, etc.



I’ve also walked providers and office staff through using SmartPhones to scan documents to DropBox using apps like Cam Scanner and then adding them to charts in a similar fashion.

Once the photos/documents have been imported into the EHR they should be deleted from the DropBox folder to make room for additional files and to help ensure that they are not mistakenly added to the wrong chart in the future. Since DropBox folders may be shared all of the members of the care team may add and update files for patients in their care.

DropBox encryption levels meet HIPAA data security standards and the user interface provides the ability to set passwords within mobile apps in addition to the security options already built-in to the device operating system. For example: I have my SmartPhone password protected and my DropBox app set with a different pass-code giving me two layers of security.  Unfortunately, DropBox has been reluctant to sign business associate agreements with health care entities so it is important that providers do not store PHI (protected health information) there.  However, their decision to avoid possible HIPAA audits has opened the door for other vendors to offer HIPAA compliant alternatives.

As digital health applications continue to evolve patients will likely be given access to upload their own wound photos via a patient web portal. This functionality could prove very advantageous to patients and providers alike by helping to cut down on unnecessary office visits for wounds that are healing well while also alerting clinicians to intervene sooner for wounds that are becoming problematic.

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