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JMIR Mhealth Uhealth. 2018 Oct 19;6(10):e11076. doi: 10.2196/11076.

Teleconsultation Using Mobile Phones for Diagnosis and Acute Care of Burn Injuries Among Emergency Physicians: Mixed-Methods Study.

Author information

Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Institute for Informatics, Division of General Medical Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States.
Goldfarb School of Nursing, Barnes-Jewish College, St. Louis, MO, United States.
Contributed equally



The referral process in acute care remains challenging in many areas including burn care. Mobile phone apps designed explicitly for medical referrals and consultations could streamline the referral process by using structured templates and integrating features specific to different specialties. However, as these apps are competing with commercial chat services, usability becomes a crucial factor for successful uptake.


The aim of this study was to assess the usability of a mobile phone app for remote consultations and referrals of burn injuries.


A total of 24 emergency doctors and 4 burns consultants were recruited for the study. A mixed-methods approach was used including a usability questionnaire and a think-aloud interview. Think-aloud sessions were video-recorded, and content analysis was undertaken with predefined codes relating to the following 3 themes: ease of use, usefulness of content, and technology-induced errors.


The users perceived the app to be easy to use and useful, but some problems were identified. Issues relating to usability were associated with navigation, such as scrolling and zooming. Users also had problems in understanding the meaning of some icons and terminologies. Sometimes, some users felt limited by predefined options, and they wanted to be able to freely express their clinical findings.


We found that users faced problems mainly with navigation when the app did not work in the same way as the other apps that were frequently used. Our study also resonates with previous findings that when using standardized templates, the systems should also allow the user to express their clinical findings in their own words.


South Africa; burns; emergency medicine; mHealth; mobile phone; referral and consultation; teleconsultations; think-aloud; usability evaluation; video analysis

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