Background
Methods
Study design, research setting and participants
Research instrument
Procedure
Statistical analysis
Results
Sample demographics
Demographics | No. | Percentage |
---|---|---|
Gender | ||
Male | 50 | 49.5 |
Female | 51 | 50.5 |
Nationality | ||
Kuwaiti | 61 | 60.4 |
Non-Kuwaiti Arab | 40 | 39.6 |
Age group (years) | ||
20–29 | 25 | 24.8 |
30–39 | 31 | 30.7 |
40–49 | 27 | 26.7 |
> =50 | 18 | 17.8 |
Mean (±SD) age/range | 39.1 + 10.7 | (20.0–72.0) |
Practitioner level | ||
Board resident | 13 | 12.9 |
Assistant registrar | 14 | 13.9 |
Registrar | 29 | 28.7 |
Senior registrar | 16 | 15.8 |
Specialist | 10 | 9.9 |
Senior specialist | 9 | 8.9 |
Consultant | 10 | 9.9 |
Smartphone technology
Accessing medical information
Medical applications
Safety of using smartphones in medical practice
Clinical photography
Clinical Photography: Use and Purpose | Gender M/F (50/51) | Nationality K/NK (61/40) | Age (yrs) ≤40/> 40 (56/45) | Position BR + C/R + S (23/78) |
---|---|---|---|---|
To take clinical photographs of patients | 31/35 | 36/30 | 33/33 | 19/47 |
p-value | 0.484 | 0.099 | 0.131 | 0.048 |
To gain advice from consultants | 22/33 | 31/24 | 31/24 | 12/43 |
p-value | 0.037 | 0.365 | 0.839 | 0.803 |
For treatment/disease monitoring | 26/31 | 33/24 | 26/31 | 15/42 |
p-value | 0.373 | 0.559 | 0.024 | 0.334 |
To share with colleagues | 24/29 | 32/21 | 28/25 | 14/39 |
p-value | 0.373 | 0.997 | 0.578 | 0.359 |
For teaching purposes | 19/22 | 26/15 | 22/19 | 14/27 |
p-value | 0.599 | 0.608 | 0.765 | 0.024 |
For research and publications | 11/11 | 12/10 | 10/12 | 8/14 |
p-value | 0.958 | 0.526 | 0.286 | 0.086 |
Perceived importance of smartphone technology
Smartphone technology: use and purpose | Response | N (%) | Mean ± SD | p-value |
---|---|---|---|---|
To take clinical photographs of patients | Yes | 66 (65.3) | 8.41 ± 1.88 | < 0.001 |
No | 35 (34.7) | 4.91 ± 2.72 | ||
To gain advice from consultants | Yes | 55 (54.5) | 8.60 ± 1.70 | < 0.001 |
No | 46 (45.5) | 5.52 ± 2.86 | ||
For treatment/disease monitoring | Yes | 57 (56.4) | 8.23 ± 2.00 | < 0.001 |
No | 44 (43.6) | 5.86 ± 3.04 | ||
To share with colleagues | Yes | 53 (52.5) | 8.40 ± 1.83 | < 0.001 |
No | 48 (47.5) | 5.88 ± 3.01 | ||
For teaching purposes | Yes | 41(40.6) | 8.51 ± 1.78 | < 0.001 |
No | 60 (59.4) | 6.70 ± 2.95 | ||
For research and publications | Yes | 22 (21.8) | 8.41 ± 1.18 | < 0.001 |
No | 79 (78.2) | 6.86 ± 2.97 |
Difficulties and challenges
Patients’ consent and privacy
Discussion
The use of smartphone technology in dermatology practice
Clinical photography using smartphone technology in dermatology practice
Privacy and confidentiality of patients’ information
Limitations
Conclusion
Recommendations
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Maintaining patient privacy and confidentiality is not only a necessity in medical practice but also part of codes of ethics, which every individual in a healthcare facility must abide by. The legal use of personal smartphones in clinical practice, therefore, requires patients’ consent, particularly when taking photographs of their bodies. Consent for taking photographs should be sought to maintain the legal protection of both the practitioner and the patient. To ensure this, a signed consent form should be stored with the photographs in the patient’s record. In the case of electronic records, a secure smartphone application can be used to incorporate smartphone photographs into the records to transmit all patient information, keeping patients’ records complete.
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For the better use of smartphones in dermatology, photographs must be taken of infected areas only (with no patient identity information) and written consent should be sought from the patients, including under-aged patients, who require parental consent. Additionally, the identity of the patient must be kept anonymous, attempting not to show scars or tattoos.
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For the safer use of smartphone technology, (1) high-security applications should be recommended for smartphone clinical use, downloaded through an online store that provides full protection of users’ information; (2) practitioners should store clinical photographs in secure areas on their smartphones and not for a long time (i.e. until they have been transmitted to the patient’s record); (3) breaches of patients’ privacy and confidentiality by practitioners would be vulnerable to legal accountability, and practitioners should be aware of this; and (4) personal conversations between senders and receivers through chatting applications should be clarified for confirmation and to avoid mistaken data inputs.
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In clinical practice, safety of the patients should be considered in regards to the smartphones use: (1) practitioners should be aware about trusted resources to obtain medical information via smartphones; (2) practitioners should avoid the distraction caused by the smartphones, particularly at the point of care to maintain the confidence between doctor and patient; also (3) attention should be given to avoid contamination when using smartphone [13], and use of barrier film to cover the device and control the infection.
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The medical board of each medical speciality should make recommendations on the best smartphone applications for clinical use. In addition, issues with technology and smartphone use should be considered and addressed regularly in meetings to find the best usage protocol to organise the work inside the healthcare facility, such as in the case of teleconsultation. Involving health informatics specialists, who specialise in both healthcare and technology, would contribute to the professionalisation of this situation.
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The Kuwait Medical Association should play a role in supporting the digitisation of medical practice, should help the medical community to adopt smart technology successfully and should prepare Kuwaiti society to adapt to this advanced technology.
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Information technology support should be offered 24/7 on smartphone use in clinical practice, including offering a Wi-Fi connection, providing workshops on using smartphones properly and resolving any technical issues.
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Patients should be made aware of the benefits of smartphone use by healthcare practitioners in treatment, education and research, and patients should be informed of their legal rights regarding privacy and confidentiality.
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Senior management should encourage medical practitioners to use the highly recommended smartphone applications for clinical use through paying the fees for these applications. Importantly, the quick guide for store-and-forward teledermatology and live/interactive teledermatology developed by the American Telemedicine Association [26] should be adopted.
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The experience of using smartphone applications in clinical practice should be explored by conducting research, offering the opportunity to identify the advantages and disadvantages.