By Ide Costa (RN, NSWOC, Ph.D.)
What is telehealth/virtual wound care?
Telemedicine is the latest, fast-developing healthcare option for many people who are unable to access face-to-face treatment due to various reasons or want to get treatment from the comfort of their home. It can be vital in the arrangement of medical services to distant and country populations. Wound care and management are prime candidates for Telemedicine across the globe.1
Telemedicine offers incredible potential for the future of chronic or long-term wound care. By lowering the need to travel significant distances to the medical clinic or to have access to specialized wound care. It also alleviates the expenses and improves the personal satisfaction for individuals with chronic wounds, while keeping up with exclusive requirements of wound treatment. The goal is to bring down the number of visits to a healthcare facility, without the intention to eliminate the consultations completely. The aim is to provide the best treatment to such individuals and take care of the apparently inevitable obstacles concerning time and money for this population who usually require many wound care consults.2
How is virtual wound care efficient when compared to face-to-face consultations?
Face-to-face consultations should be restricted to only unavoidable situations where virtual care cannot suffice. Regular wound care can easily be facilitated through Teleconsults using Telehealth platforms that follows HIPPA regulation for a safe and confidential environment. It not only helps the patients in cost reduction with transportation but also to have timely access to specialists from unserved areas to evaluate their wound with great detail. 3
Virtual care also makes the process more convenient, as people with chronic wounds find it challenging to travel long distances to have an extra appointment. Telewound care has been recognized as effective as in-person visits by wound care specialists and Wound Care societies. Through photography and video-based communication, healthcare providers can obtain a detailed history, visually assess the wound, and answer any questions in a similar fashion to a face-to-face visit. For instance, following a structured protocol, the wound care experts can assess the wound and receive images through a safe and secure chat-like environment. The provider may be using a two-way camera. 4 From there a plan of care can be developed and wound supplies are then delivered by home care agencies, all done from the convenience of the patient’s home. Listed below are the advantages of virtual wound care:
- Decrease or eliminate wait time
- Decrease in emergency visits
- Easy follow up for chronic and post-surgical wounds
- Individual benefits from a streamlined care plan
- Wound care supplies delivered to home
Possible drawbacks and how to resolve them
There are some situations in which telewound cannot replace real face-to-face care. For example, insufficient knowledge or careless attitude of the nurse entering the data or the data not being clear enough for the specialists to analyze. There is another limitation; that of a conflict in the care plans of the Tele wound-carer and the physician providing wound care. These errors can be resolved through proper training, better communication, and more detailed coordination and collaboration between the online caregiver and the physician of the patient. However, with treatment modalities changed or adapted in one-third of the consultations, there was a significant decrease in visits to a general practitioner who would have more time to focus on other health issues of the patients.
Situations where tele-wound care may not be appropriate
Though, the use of wound telemedicine systems in the home care environment has been expanding for the last decade. It is important to recognize that Telewound care is not for everyone. Below we have listed a few situations where virtual wound care would not be appropriate:
- Technological barriers– example: lack of Internet or unstable Internet connection, lack of devices that are capable of telehealth.
- Individuals with suspected critical or severe conditions should be recommended to receive a thorough evaluation and in-person follow-up until the condition stabilizes.
- Individuals, families, or care-givers who are unwilling or unable to engage in virtual care.
- Individuals or families who are unwilling to get engaged in self-management of wounds.
- Caroline Chanussot-Deprez, José Contreras-Ruiz Telemedicine in Wound Care: A review. 2013 Feb;26(2):78-82. doi: 10.1097/01.ASW.0000426717.59326.5f.
- Jones S, Banwell P, Shakespeare P. Telemedicine in wound healing. Int Wound J. 2004;1(4):225-230.
- Emily C. Mills, BA, Elizabeth Savage, MSN, RN, ACNS-BC, CWON, IIWCC-NYU, Jessica Lieder, MSN, RN, AGPCNP-BC, CWON, IIWCC-NYU, and Ernest S. Chiu, MD, FACS Telemedicine and Covid-19 Pandemic: Are we ready to go?. 2020 Jun 8: 10.1097/01.ASW.0000669916.01793.93
- Mufti A, Sachdeva M, Maliyar K, Sibbald RG. COVID-19 and wound care: A Canadian perspective. JAAD International. 2020;1(2):79-80. doi:10.1016/j.jdin.2020.05.003