Smartphone photography by patients in telemedical wound assessment 151 1. Introduction In the last decades, a decline in hospital length of stay has been observed, including early discharge after percutaneous cardiac intervention. Consequently, patients may face postprocedural complications after hospital discharge. Important complications may include hematoma, bleeding, and infection, which often occur within 4 days after the intervention (1). Most patients, however, are discharged on the day of the procedure or the day after. Early discharge may be accompanied with having a complication in the domestic situation and consequently may need an evaluation by a healthcare professional. It is to be expected that patients who worry about having a complication contact the hospital (ward) that performed the intervention, most often by telephone. One limitation of this remote contact is the lack of visual wound inspection, which may initiate a follow-up visit to reassure patients or confirm and treat a complication. An alternative to clinical assessment may be remote assessment of clinical pictures, which has been implemented successfully by several medical subspecialties and in different clinical situations (2-4). Mobile telemedicine is a recent development in which patients use their mobile phones (3). It can offer a safe and cost-effective form of communication (5). Mobile phones are often personalized, which can reduce the barriers in the use and acceptance of health interventions with it (6). The camera function has become integrated in almost all mobile phones (6). Consequently, we can make use of this integrated function in mobile phones in the context of remote ‘‘monitoring’’ or telecare until the first followup visit (range, 10 days to 3 months) after an invasive procedure with early discharge. In this study, we focused on patients who underwent an electrophysiological treatment (e.g., device implantation or treatment of a dysrhythmia). The aim of this pilot study was to evaluate the feasibility of augmenting post discharge telemedical wound assessment by using a mobile phone for making and sending photos of an intervention-related wound in patients undergoing an elective cardiac intervention. 9
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