Role of mobile multimedia messaging service (MMS) in trauma and orthopaedic telediagnosis

Introduction Mobile Multi Media Messaging Service (MMS) is globally available for sending pictures over public mobile phone networks. Use of this technology in different Welds of medicine so far has been limited because of the low resolution of capturing camera and small size of mobile phone displays. Use of this service can improve patient care as waiting times would be reduced for a final management decision in Emergency Room, making instant decision by junior doctors in getting senior advice regarding admission or discharge. This can be particularly helpful where senior advice is not available on site e. g. non-resident on call, split sites, busy in theatres or clinics. It can also be very helpful in transferring images internationally for expert opinion. Objective This study was designed to assess the reliability and accuracy of diagnosis, ease of use, any change in management decisions for X-rays sent using multi-media messaging service (MMS), for an instant decision verses hard copy or PACS images. This was used between orthopaedic first on call and the middle tier, using GPRS Service on public mobile network. Materials and methods X-rays of 89 consecutive patients referred to Trauma & Orthopaedics at a District General Hospital were used for this study. 2 MMS enabled PDA's (XDAIIi) (with Software to enhance the image) were used for this study. One PDA was given to the Orthopaedic first on call SHO, while the other was given to the Orthopaedic registrar on call. Images were taken and sent by using GPRS Public Mobile Network as a MMS. The same registrar also reviewed the images on hard copies afterwards and compared them with the received images on the PDA for quality, reliability, any discrepancy in the diagnosis or change in the management plan compared to that initially made on receiving MMS X-rays. Results Eighty-nine X-ray images were sent and assessed for any discrepancy in diagnosis. High reliability was noted for trauma images. The time to decision was shortened in all cases resulting in better patient care. Conclusion X-rays transferred as MMS images for diagnosis in Trauma & Orthopaedics is a reliable method, using an bigger display screen and improved resolution of captureing camera. This is also quick resulting in decrease of 'time to decision' and improving quality of care as each Xray is reviewed immediately by senior on call. We recommend the use of MMS and its availability to the on call staff working in Trauma and orthopaedics for quick and improved patient care.