St. Louis-based Ascension aims to make telehealth more equitable when identifying injuries remotely.
The 134-hospital system is researching how best to capture images with smartphones to account for various skin tones when virtually diagnosing bed sores or pressure ulcers.
"How do we make sure we have strong, high-quality images of patients within telehealth? And how do we guide patients and clinicians to take good pictures?" Cynthia LaFond, PhD, RN, senior director of nursing research at Ascension, told Becker's. "And can we have a digital application with a strong database of diverse, high-quality photos to help us diagnose these patients sooner using video or a camera?"
Ascension is working with Milwaukee-based Marquette University after receiving a $20,000 grant to improve telehealth equity. The study will feature about 30 standardized patients (i.e. actors) in Illinois, taking over 40 photos per patient. One of the researchers is developing a smartphone app.
The health system will examine how room lighting and instructions to patients affect the photos. The researchers will try taking photos with and without flash, the patients' skin moisturized and not.
"Are there certain populations that we should be using thermography scanners and a subepidermal moisture device on?" Dr. LaFond said. "When should we be using these, on which patients and at what time?"
Ascension got started on this work after identifying "a gap in the literature" on how skin tone diversity is represented in virtual care, she said. After all, skin tones can vary widely, even within races.
"Ultimately, we'd have standards to help us to take these images and incorporate them into patient education, as well as clinician education," Dr. LaFond said. "Because there's a lack of diverse images in text, and sometimes even the same images are being used over and over again across textbooks, because of the lack of images with dark skin tones. We need to make sure our clinicians are comfortable identifying how something might look differently across different populations."
The health system is also analyzing the data of 55,000 patients from the International Pressure Ulcer Prevalence Survey to further study the relationship between skin tone and pressure injury severity.
"We're hoping this will ultimately give us evidence-based guidance on how best to take digital images and support high-quality images for all, good diagnosis for all," Dr. LaFond said.