Let's be frank: wound care telemedicine cannot replace a visit to a physician's office or the wound care center. Telemedicine was primarily developed to reduce visits and help serve people living in rural communities. However, telemedicine can supplement advanced wound care in many ways, and has been proven to be time saving and effective. Telemedicine in wound care has its pros and cons (like anything else), but with a protocol-driven approach, it is effective for wound healing.

How Does Telemedicine in Wound Care Work?

LINK... TREAT... BILL. Telemedicine allows us to treat patients any time and anywhere. Telemedicine in wound care can be done utilizing a smartphone, video camera (two-way), and electronic medical records to store and exchange medical information. Following a structured protocol, the home health nurse will assess the wound and receive images. The provider may be on a two-way cam, or receive securely transmitted information. From there, a plan of care is developed and wound supplies are then ordered/delivered. This is all done from the convenience of the patient's home. Connecting with a home health nurse or wound certified nurse is beneficial in bridging the gap between education and wound assessment.

Advantages and Disadvantages of Wound Care Telemedicine

Advantages:

• No appointment wait time
• Decrease in Emergency Department visits
• Follow up on post-surgical and chronic wounds
• Fewer hospital stays
• Convenience from patient’s home
• Develops essential bond between patient and provider
• Streamlined care plan
• Less pain for patient (ride to appointment)
• Cost effective (ambulette, caregiver escort, gas, etc.)
• Wound care supplies delivered to home
• Enhanced quality of life
• Improved clinical outcomes

Disadvantages:

• Lack of hands on wound assessment (palpation, depth)
• Inability to detect odor
• Possible learning curve for patient with technology
• Diagnostic accuracy
• Complex wounds may need to be referred for debridement, procedures, etc.

In general, telemedicine technology can provide 24 hour access from any location. Patients with non-complex wounds would be ideal candidates for wound care delivery via telemedicine. In terms of telemedicine fees, a single patient tele-visit typically costs a flat rate of $40 - $120. Patients that can use telemedicine may be more compliant. Wait time, transportation, and cost are a few of the advantages. Telemedicine will ideally help triage urgent requests, streamlining care delivery. Wound care patients presenting infection, in need of debridement, and/or procedures would be referred accordingly.

References:
Advanced Tissue. Tele-Wound Care: The Use of Telemedicine in Ongoing Wound Care. Advanced Tissue website. http://www.advancedtissue.com/tele-wound-care-the-use-of-telemedicine-i…. October 22, 2015. Accessed January 20, 2017.

Chanussot-Deprez C, Contreras-Ruiz J. Telemedicine in wound care: a review. Adv Skin Wound Care. 2013 Feb;26(2):78-82. doi: 10.1097/01.ASW.0000426717.59326.5f.

Loehne HB. Telemedicine: The Key to Opening the Door to Wound Closure in Rural Communities. Todays Wound Clinic. 2012 Sep;6(7). Available online at:http://www.todayswoundclinic.com/articles/telemedicine-key-opening-door…

Ong CA. Telemedicine and wound care. Stud Health Technol Inform. 2008;131:211-25.

UberWoundCare

About the Author
Cheryl Carver is an independent wound educator and consultant. Carver's experience includes over a decade of hospital wound care and hyperbaric medicine. Carver single-handedly developed a comprehensive educational training manual for onboarding physicians and is the star of disease-specific educational video sessions accessible to employee providers and colleagues. Carver educates onboarding providers, in addition to bedside nurses in the numerous nursing homes across the country. Carver serves as a wound care certification committee member for the National Alliance of Wound Care and Ostomy, and is a board member of the Undersea Hyperbaric Medical Society Mid-West Chapter. She is the first LPN to be inducted as an Association for the Advancement of Wound Care (AAWC) speaker.