As the American population ages, the principles of wound care will become ever more important to ensuring that patients enjoy comfort and high quality of life during their later years. Elderly and infirm individuals who live in skilled nursing facilities and long-term care centers tend to suffer serious skin breakages at higher rates than members of the general population. Their advanced age, drug regimens and other medical issues may reduce their ability to heal on their own, necessitating intensive wound care routines that stabilize and manage these problems.
A Vital Component of Elder Care
Wound care is already critical to managing the recovery of patients who have endured complex gastrointestinal surgery, localized radiation treatments and other procedures that can adversely impact the body’s ability to repair itself. Fistulas, skin ulcers and other types of chronic wounds can persist for months and years. In the absence of proper management, serious complications can result.
That said, first-rate wound care is a complicated prospect, and many rural patients miss out on critical opportunities – including sessions in hyperbaric chambers and grafting surgeries with wound repair specialists – that can shorten their recovery times and improve their outcomes. While it’s impossible for rural residents to access oxygen chambers and world-class surgeons without physically traveling to regional wound care centers, telemedicine has dramatically improved access to other tools that may be just as important in the long run.
Telemedicine and Rural Wound Care: Case Studies
Multiple studies have shown that rural wound care patients benefit from access to telemedicine. A 2011 study by researchers at Austria’s University of Graz looked at the “teledermatology” outcomes of 14 patients with 41 individual chronic leg ulcers between them. These patients had limited mobility and found it difficult to leave their homes or long-term care facilities.
Instead of traveling to a faraway clinic or working with at-home nurses, the patients used telemedicine technology to send several high-resolution images of their wounds to wound care specialists in remote locations. Pertinent medical data was also sent with these images. The remotely located experts analyzed the images and provided clinical recommendations for at-home or in-facility treatment, including recommending in-person nurse visits for patients whose conditions had deteriorated over the previous week. The vast majority of remote consultation sessions were effective, and the study’s authors reported a dramatic decrease in the number of in-person visits required to provide basic wound care for the studied patients.
Another recent meta-study that appeared in the February 2013 issue of Advances in Skin & Wound Care found similar results in a larger population of wound care patients.
According to study leaders Drs. Caroline Chanussot-Deprez and Jose Contreras-Ruiz, “[t]he availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make the assessment of wound status by remote experts possible” on a sustained basis. The authors touched on the work of the University of Graz team, noting that digital capture technology is now sufficient to consistently deliver clinical-grade images of patients’ wounds from virtually anywhere. Their study also found a “high accordance for diagnosis and treatment between face-to-face visits and teleconsultations has been reported,” suggesting that dermatological experts who consult with patients via telemedicine are no more likely to misdiagnose wound issues than peers who consult in person.
A Bright Future for Telemedicine in Chronic Wound Care
Telemedicine technology has seen some early successes in addressing the needs of chronic wound care patients, and further technological and procedural advances look likely to further improve care delivery, outcomes and overall experiences for rural patients who live in skilled nursing facilities, long-term care facilities and private residences. By significantly reducing the need for long-distance travel or in-home consultations, telemedicine also promises to reduce the overall cost of care for wound care patients and their insurers. Stakeholders at every link in the chain of care stand to benefit.