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PHC Introduces Cutting-Edge Technology

Lower leg wounds are common among patients receiving home health care. Wounds can be painful, immobilizing and recurrent. Treatment and monitoring of wounds is intensive, requiring a high level of involvement on the part of home care nurses. With that in mind, Partners Home Care (PHC), in collaboration with Partners Telemedicine, began a pilot project that uses cutting-edge technology for treating lower leg wounds. The primary aim of the project is to evaluate the impact of telehealth on the quality and cost of care for lower leg wounds among PHC patients. In this study, the Telehealth intervention refers to the use of a web-based wound application with digital imaging to obtain specialized consultation from an Enterostomal Therapy Nurse (ETN).

Traditionally, when a visiting nurse had a patient with a lower leg wound that was not healing, he or she made a referral to Barbara Norkus, RNC, CWOCN, Coordinator of the Wound and Ostomy Program at PHC. Prior to this technology, Norkus had to depend on the nurse's description in order to address the patient's wound healing issues. If Norkus wanted to physically assess the wound herself, she would have to drive to the patient's home. With over 140 communities in the PHC service area, she could only see a handful of patients on any given day. Now, for patients who have agreed to be part of the project, the nurse does an assessment and takes a photo of the wound. The assessment and digital image is entered into a secure web-based computer application by the visiting nurse, and Norkus is notified that the information is available to her for consultation. She reviews the patient's assessment data and digital images and uses them to make her treatment recommendations. "At first, I was hesitant about making a diagnosis through pictures," says Norkus. "But the clarity, quality and sharpness of the pictures is very impressive."

All the nurses who participate in the project have had additional education on caring for patients with wounds and on the use of the Telehealth Computer. "For some of the nurses there was a learning curve because they were not familiar with using computers in this way, and many had never used a digital camera," says Leslie Vickers, RN, MS, CRRN, Program Development Director. "But we did extensive training on how to use the computer and how to take the pictures. All the nurses who are now participating are excited to be part of the pilot project."

Although the project has been piloted in the Affiliated Community VNA, the South Region Branch of PHC, plans are underway to apply for further funding which would allow additional study of the process and would expand the program to other branches of PHC. "We have just begun to collect data to evaluate the benefits of the program," says Vickers. "But what we have seen so far is that we are able to see more patients and there is a faster time frame in receiving treatment. The computer allows our wound care nurse to use her time more efficiently."

Norkus says she heard about this technology six years ago. "I was at a conference on Telemedicine, and at the time, this technology was being used by the military. It's exciting to think that we are able to use this state-of-the-art equipment to help patients at Partners Home Care!"