Dr. Jeffrey T.S. Hsu
Whether the devices are used for sharing before and after photographs of cosmetic procedures, allowing patients to watch informational videos about specific procedures, or offering them the opportunity to watch a movie while waiting for topical anesthetic to take effect, tablets have the potential to increase patient satisfaction, optimize patient education, increase clinic efficiency, and enhance the overall patient experience (Sem. Cut. Med. Surg. 2012;31:200-2).
"Patients coming into the clinic for cosmetic procedures have questions, such as, ‘What will I look like after the procedure?’ and ‘Will there be scarring?’ Instead of describing the result and fueling their imagination, we give them an iPad to browse through numerous before and after photographs that serve as examples of patients who have had the same procedure," Dr. Hsu and his colleagues reported. Choosing a representative set of before and after pictures sets realistic expectations.
Among the "pros" of using the iPad is its ease of use. The device is lightweight and well suited for patients to hold one-handed while standing, sitting, or lying down. The touch screen allows for easy scrolling and zooming while viewing images. "It also simplifies categorization of photographs, allowing patients to review different examples of procedures based on location, size, gender, and ethnicity," the authors noted.
Disadvantages include the price, which is higher than many traditional notebook computers that can also be used to display pictures. Some users also find the virtual keyboard of the iPad to be cumbersome. The device can be damaged more easily than traditional notebooks, but a protective case can reduce the risk.
Optimal use of the iPad requires proper set-up with separate folders for each procedure and perhaps additional folders based on gender and ethnicity. Privacy and security are also paramount.
"Regardless of the method used to display the pictures, informed consent for using a patient’s pictures for educational purposes must be obtained prior to displaying the pictures," they wrote, noting that the device should be password protected in case it is lost or stolen.
The authors noted positive feedback from patients regarding the addition of the tablet computer during consultations. They reported having no conflicts of interest.
Digital Clinical Photography
The use of clinical photography in dermatologic practice is nothing new, and in fact has been accepted for decades as a standard means for documenting dermatologic conditions and as an adjunct to treatment. However, the emergence of high-quality, low-cost, digital imaging systems is making quality imaging more accessible to practitioners, and expanding its applications, according to William K. Witmer, director of DermaTrak Skin Imaging Centers in Fairfield, N.J., and his colleague.
Not only is clinical photography useful for documenting conditions and treatment, it is also valuable for monitoring at-risk patients and for professional and business development (Sem. Cut. Med. Surg. 2012;31:191-9).
Mr. Witmer and his colleague provided a number of tips for optimizing use, including how to select the right equipment for a particular practice – a special purpose system such as a dermatoscopic or a 3-D system may be useful for certain highly specialized practices, for example.
As for lighting systems, they recommended purchasing a camera-mounted flash for close-up photos and external studio lighting if space permits. Also, consider special purpose systems, such as ultraviolet systems, for imaging subsurface pigmentation.
"Because the outcomes of dermatology treatments typically result in a visible change to the patient’s appearance, photography is a natural adjunct to these procedures. For almost any procedure, you’ll want pictures before the treatment to establish a baseline, during the treatment to monitor progress, and at completion to document the results. Over time, these photographs will comprise a valuable professional resource," they wrote. They will also form an important part of the patient records and enable clear evidence-based communications.
Mr. Witmer’s colleague, Peter J. Lebovitz, is marketing manager at Canfield Imaging Systems in Fairfield. Mr. Witmer disclosed receiving payment for lectures from the Nevus Outreach Program.
Social Media
Patients’ use of social media for accessing medical information has accelerated, and dermatologists would do well to keep pace, according to Dr. Robin Travers.
Dr. Travers, in private practice in Chestnut Hill, Mass., provided a five-step plan for active engagement in social media applications.
Step 1: Identify audience and goals. Step 2: Research and test the waters. Step 3: Identify staff members and patients who are social media enthusiasts and enlist their help in developing social media programs. Step 4: Assess resources and select one or two platforms to focus on. Step 5: Define what success will look like and monitor progress (Sem. Cut. Med. Surg. 2012;31:168-173).