For patients with acute and chronic wounds, remote wound assessment and management via telehealth is improving healing times and providing patients with greater quality of life.
Telehealth is emerging as a game changer in the assessment and ongoing treatment of patients with acute and chronic wounds by enabling decision making at a distance.
Virtual technology is improving healing time and health outcomes by connecting remote patients with wound-care specialists. It is also a cost-effective treatment option.
Let’s take a look at virtual wound-care management, and how a busy regional hospital and an isolated worksite are two Australian locations using the Visionflex clinical telehealth system to improve outcomes for remote wound patients.
Acute wounds are classified as either accidental or surgical wounds, while chronic wounds are defined as wounds that have failed to heal or to reach anatomic and functional integrity. There are four categories of chronic wounds – arterial ulcers, diabetic foot ulcers, venous leg ulcers, and pressure injuries.
Chronic wounds are highly prevalent in Australia: According to Wounds Australia, the country’s peak body for wound prevention and management, every year more than 420,000 Australians suffer from chronic wounds.
The associated healthcare-related costs for wound treatment are considerable – equivalent to more than AUD$3.5 billion, which is approximately two percent of national healthcare expenditure. Read more here.
Chronic wounds are painful and leave patients at a higher risk of infection, hospitalisation, and decreased ability to self-care. This can translate to increased psychosocial and economic distress, which in turn can further reduce a patient’s ability to heal. Read the article.
With Australia’s ageing population and obesity epidemic, it is predicted that the incidence of chronic wounds will only continue to increase. Elderly people are particularly susceptible to chronic wounds due to their age, immobility, and comorbidities such as diabetes mellitus.
The Royal Commission into Aged Care Quality and Safety also raised wound management as an area requiring improvement in the residential aged care sector.
Accessing timely and effective wound care services can be problematic. According to Wounds Australia, specialist wound care is patchy and almost non-existent in rural and remote areas.
There is a reliance on hospital staff, who are operating at capacity, to deliver wound care; while most wound care specialists – including GPs, nurse practitioners, wound clinical nurse consultants, podiatrists, and other allied health care workers – are outside the hospital system. Wound care doesn’t have a dedicated MBS item number and there are no subsidies for dressings.
Lithgow Hospital – a busy regional hospital
The Visionflex clinical telehealth system is being used for remote wound assessments, connecting patients at NSW’s Lithgow Hospital with wound specialists at Nepean Hospital via video call.
Prior to using the Visionflex system, patients and an accompanying nurse were transported by ambulance for the 180-minute return journey between hospitals to attend wound-review consultations in person.
Lithgow Hospital’s Visionflex wound-care toolkit comprises: the ProEX Telehealth Hub with powerful built-in video-call software; the GEIS® General Examination Camera HD; and an ergonomic Visionflex Cart for easy transport around the hospital.
Lithgow Hospital patients and physiotherapists can now connect with remote medical specialists via high-speed, high-definition, encrypted video conference software for real-time, clinical patient examinations and reviews.
A Lithgow Hospital physiotherapist said: “Using the telehealth system allows us to interact with both patient and a remote specialist at the time of the consult. This allows us to ask questions or seek more specific information both from our perspective and other patients’, allowing a better experience and potential treatments.”
ExxonMobil – an isolated work site
In the Bass Strait, ExxonMobil Australia operates 23 offshore platforms and installations, 14 of which are manned.
Up to 300 personnel are living and working offshore at any one time. The platforms operate 24 hours a day and crews typically work 12-hour shifts on a seven-days-on and seven-days-off roster.
All ExxonMobil remote sites have highly competent first aid trained staff who liaise with the company’s onshore clinical staff for additional support.
ExxonMobil is using the GEIS® General Examination Camera HD across its operations in the Bass Strait to provide a detailed view of wounds, abrasions, and skin rashes during medical consultations.
Importantly, according to ExxonMobil Australia’s Managing Director Medicine and Occupational Health, Dr Marcus Hirschfield, telemedicine utilising the GEIS® camera is improving outcomes for patients and clinicians.
“The cameras have definitely improved our service delivery in remote locations by providing clearer visuals when needed during a medical examination,” said Dr Hirschfield.
“The benefit in using telemedicine that utilises the GEIS® camera, is that it provides comfort and support to both the person providing first aid and the patient, by having the visuals and the feeling of a ‘doctor/medic in the room’ rather than relying on telephone discussions.
“The higher resolution close-up views afforded by the GEIS® cameras are very helpful to our clinicians.”
The Visionflex wound-care solution
Detailed wound and skin assessments are conducted with the easy-to-use, hand-held GEIS® camera. This multi-purpose examination camera was developed specifically for telehealth applications to capture and display full HD video and 1080p-resolution images of a patient encounter.
The GEIS® camera comes with a dermatology hood for clear, close-up images of the skin and eyes, as well as a wound measurement stick for consistent imaging of wounds from 20cm, with a marked 40mm end for easy measuring.
The ProEX system – which includes the ProEX Telehealth Hub and the ruggedised ProEX Mobile tablet version – can be used to perform synchronous and asynchronous (store-and-forward) wound-review consultations, making it an ideal wound-care solution for hospital rounds and field visits to areas with limited, or no, connectivity.
Visionflex’s high-speed, secure, video-call technology is specifically designed for health professionals, enabling them to collaborate and engage with patients for evidence-based diagnoses and treatment plans.
The Visionflex system automatically saves patient data to a practice management system, a network, or an electronic health record, making it easy to reference wound healing data and media over time.
The benefits of virtual wound care
Clinical telehealth technology can be used to remotely analyse and monitor wounds, to triage patients with wounds, and to develop management plans for patients with chronic, problematic wounds. Visionflex technology delivers wound expertise to the point of need, improving access, treatment times, and health outcomes. A 2012 assessment of a virtual wound management pilot in India determined that:
- digital images for skin lesions are safe, accurate and a cost-effective referral pathway
- virtual wound-care services enhance communication with surgical wound-care specialists
- telehealth is particularly useful for managing chronic wounds that require a long duration of treatment with frequent monitoring and several follow-up visits
- telehealth is useful for reducing travel expenses and prolonged wait times for appointments
- in the hands of an experienced physician, telehealth technology streamlines management of problem wounds
- telehealth ameliorates low availability of wound specialists and reduces access time.
The Indian pilot, which was used to reach needy and underserved populations, utilised 306 remote/rural/district hospital/health centres, and 16 mobile telehealth units connected to 60 super speciality hospitals located in major cities. The pilot used both synchronous and asynchronous consultations to assess wound patients and connect with remote specialists.
As an additional example: A 2020 US article on telehealth wound care solutions found that a hybrid approach combining outpatient clinic visits with telehealth consultations increased the frequency of complete healing and the healing rate of diabetic foot ulcers, as well as reduced frequency of limb amputation.