Wound Care Monitoring
Summary:
This trial evaluated the value and feasibility of implementing a wound telehealth consulting system to wound patients in the home care environment. In allowing wound care specialists to remotely evaluate patient images and data from their desktops, the study was able to determine whether the system could improve efficiency while improving quicker access to specialist care.
Study Overview:
Early wound diagnosis and treatment increases the quality of care to the patient and decreases overall health care costs. Wound care nursing specialists provide this care, but unfortunately there are insufficient number of them to meet the growing demands of the home health care patient population. Only the most serious wounds can be evaluated directly by a wound care specialist.
In collaboration with Partners Home Care, we developed the Wound Telehealth Consultation System (WTCS), a web-based software application and imaging system that allows the wound care nursing specialists to evaluate wounds from a computer. Home care nurses could then digitally image the wound and upload pertinent medical information and electronically transmit the data to a wound specialist. In this system, a wound care nursing specialist can evaluate a wound every 10 minutes, compared to the 1.5-2 hours it takes her to make a house call.
The trial began in 2002, which included thirty-four patients admitted to Partners Home Care with lower extremity wounds. Patients were imaged according to a three-image protocol by a home care nurse, who uploaded the images and pertinent information into WTCS. Efficiency gains, as well as overall usability and workflow impact were evaluated.
Results:
The study demonstrated clearly that using WTCS can be an efficient means of delivering quality wound care to home health patients. An average time reduction of 2.5 hours per wound care specialist assessment was determined. The trial also demonstrated differing diagnosis and treatment plans between home care nurses and the wound care nursing specialists.
In March 2003, Partners Home Care began to roll out WTCS on a branch-by-branch basis for all wounds that required daily care. Wounds in the following categories are being imaged: statis, traumatic, surgical, and pressure. Imaging is performed by a commercially available digital camera, although further workflow improvements using a cell phone camera is planned. Other program improvements, such as better user interface design, is also being evaluated. The goal is to seamlessly integrate WTCS as part of the Partners Home Care Standard of Practice.