Appl Clin Inform 2020; 11(05): 764-768
DOI: 10.1055/s-0040-1718754
Research Article

Patient Portal, Patient-Generated Images, and Medical Decision-Making in a Pediatric Ambulatory Setting

Karolin Ginting
1  Department of General Surgery, The Jewish Hospital, Cincinnati, Ohio, United States
Adrienne Stolfi
2  Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
Jordan Wright
2  Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
Abiodun Omoloja
2  Department of Pediatrics, Wright State University Boonshoft School of Medicine, Dayton, Ohio, United States
› Author Affiliations
Funding None.


Background Electronic health record (EHR) patient portals are a secure electronic method of communicating with health care providers. In addition to sending secure messages, images, and videos generated by families can be sent to providers securely. With the widespread use of smart phones, there has been an increase in patient-generated images (PGI) sent to providers via patient portals. There are few studies that have evaluated the role of PGI in medical decision-making.

Objectives The study aimed to characterize PGI sent to providers via a patient portal, determine how often PGI-affected medical decision-making, and determine the rate of social PGI sent via patient portal.

Methods A retrospective chart review of PGI uploaded to a children's hospital's ambulatory patient portal from January 2011 to December 2017 was conducted. Data collected included patient demographics, number and type of images sent, person sending images (patient or parent/guardian), and whether an image-affected medical decision-making. Images were classified as medical related (e.g., blood glucose readings and skin rashes), nonmedical or administrative related (e.g., medical clearance or insurance forms), and social (e.g., self-portraits and camp pictures).

Results One hundred forty-three individuals used the portal a total of 358 times, sending 507 images over the study period. Mean (standard deviation) patient age was 9.5 (5.9) years, 50% were females, 89% were White, and 64% had private insurance. About 9% of images were sent directly by patients and the rest by parents/guardians. A total of 387 (76%) images were sent for medical related reasons, 20% for nonmedical, and 4% were deemed social images. Of the 387 medical related images, 314 (81%) affected medical decision-making.

Conclusion PGI-affected medical decision-making in most cases. Additional studies are needed to characterize use of PGI in the pediatric population.


Results of this study were presented in part as a podium presentation at the 2018 Pediatric Academy Association annual meeting in Toronto, Canada. The first author, K.G., was a final year medical student at the time the study was conducted and presented at the PAS.

Protection of Human and Animal Subjects

The study was performed in compliance with the World Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was conducted after approval from the institutional review board of the study site. This study was conducted after approval from the Dayton Children's Hospital Institutional Review Board.

Publication History

Received: 01 May 2020

Accepted: 10 September 2020

Publication Date:
18 November 2020 (online)

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