Plastic surgery telehealth consultation expedites Emergency Department treatment

Angie M. Paik, Mark S. Granick, Sandra Scott

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Plastic surgery is a field that is particularly amenable to a telehealth milieu, as visual exam and radiographs guide proper diagnosis and management. The goals of this study were to evaluate telehealth feedback executed through an iPad app for plastic surgery-related consultations. A Quality Assurance/Quality Improvement (QA/QI) study was conducted over a 1-month period during which patients with hand injuries, facial injuries, or acute wounds presenting to the Emergency Department (ED) of a level-one trauma centre and university hospital were monitored. The study utilized a commercial iPad application through which up to four images and a brief history could be sent to a remote Plastic Surgery Educator (PSE) for evaluation. The PSE would respond with best practice information, references and videos to assist ED point-of-care providers. During the 1-month period of this study, there were 42 ED consultations for plastic surgical conditions. There was a highly significant difference in overall mean response time between consultants and PSEs (48.3 minutes vs. 8.9 minutes respectively, p < 0.001). The agreement between PSEs and consultants regarding patient assessment and care was 85.7% for in-person consultations and 100% for phone consultations. In four cases of telephone consultations, the ED providers placed splints incorrectly on hand-injured patients. Our results show that telehealth consultations to a remote plastic surgeon based on digital images and a brief history were able to produce timely and accurate responses in an emergency care facility. This design may have significant impact in rural areas, underserved populations, or regions abroad.

Original languageEnglish (US)
Pages (from-to)321-327
Number of pages7
JournalJournal of Telemedicine and Telecare
Issue number2
StatePublished - Feb 2016

All Science Journal Classification (ASJC) codes

  • Health Informatics


  • Emergency Consultation
  • Quality Assurance/Quality Improvement (QA/QI)
  • Telehealth
  • Telemedicine
  • plastic surgery


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