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Use Case:
Plastic Surgeon In-patient Referral

Other Use Cases

Case2
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Scenario

3:41 pm. The emergency department treats a patient's infected wound. The Emergency resident thinks a plastic surgeon should be consulted.

With PicSafe®

3:46 pm. The nurse uses PicSafe® to take a photo (as per above example).

3:46 pm. The nurse enters the patient details and records the patient's consent (the patient signs on screen after reading/understanding potential usage of their photo).

3:47 pm. The nurse emails the encrypted photo to the plastic surgeon (and concurrently uploads the report to the appropriate medical record).

3:48 pm. The nurse dresses the wound.

3:58 pm. The plastic surgeon’s assistant shows the photo (via secure PicSafe) to the surgeon while in theatre on another case. She dictates the surgeon’s brief treatment instructions in reply for ED nurse.

4:14 pm. The ED nurse finishes dressing the wound and then arranges admission, etc.

Without PicSafe

3:46 pm. The Plastic Surgeon is summoned via telephone. Her rooms inform the ED nurse that the surgeon is likely to be in theatre until later that evening, depending on "how the case goes".

3:49 pm. The ED nurse then goes to find the ED attending physician/registrar to discuss case regarding what to do until the surgeon can arrive.

3:55 pm. The ED nurse, therefore, starts dressing the wound.

4:21 pm. The nurse finishes dressing the wound. In the meantime, the patient waits ("is parked") in ED. The patient and family are unhappy.

7:41 pm. The surgeon finally arrives. She is tired and wants to finish evening rounds. She locates the nurse and patient, takes down the dressing, and performs a cursory examination of the wound.

7:49 pm. She gives further treatment instructions and informs the patient that they will "have to spend the night as there are no clinics open at this hour, and we’ll ultimately need to graft the wound anyway".

7:55 pm. The nurse re-dresses the wound.

8:21 pm. After completing the wound dressing, patient’s admission is then arranged. The patient, the family, and admissions/bed-control are all unhappy.

The Result (absent PicSafe):

  • A minimum of an additional 40 minutes of nursing time is required (approximate cost $36).
  • A minimum of an additional 20 minutes of surgeon’s time required (approximate cost $54).
  • Additional consumables are expended (i.e. dressing materials - approximate cost $30).
  • The patient treatment time and wound manipulation are extended, thereby increasing the risk of infection.
  • The patient experiences increased pain and suffering. Family members are distraught.
  • There are no pictorial records of the wound in the medical record for progress evaluations or should there be later complications requiring review.

The Cost Savings (with PicSafe)

  • A minimum extra incremental cost of $120 per episode is eliminated.
  • The Plastic Surgeon estimates that they see one case like this each day and there are three plastic surgeons at her hospital. That translates into approximately 1,095 similar cases each year.
  • Yielding conservative potential cumulative savings of $120 x 1,095 = $131,400 per year result on this simple case-type alone.
  • As surgeons and physicians, we know first-hand that the above scenarios are, both, conservatively presented and very realistic.
  • This scenario cannot quantify other factors such as:
    • The pain and suffering component of the patient,
    • Risks attendant to "tired decision-makers",
    • Risks of "prolongation beyond protocol" of patient wait-time, with its own inherent risks, if the illness/injury is life-threatening;
    • Nor do the above estimates attempt to quantify the all-important subjective patient, family, and hospital staff dissatisfaction levels resulting from such all-too-common scenarios.

In Summary

If a photo was taken with PicSafe® and sent to the surgeon:

  • The patient exposed to less pain and they then give better patient satisfaction scores.
  • The hospital saves over $130,000 in time and consumable costs per year.
  • There is reduced legal (malpractice, malfeasance) and reputation risk.