Using digital images in wound care
MedCom and the Municipality of Guldborgsund, Denmark
Frank and Liz’s stories
Frank is 85 years old and lives at a care home, suffers from several co-morbidities and is very difficult to mobilize. While Frank’s social network is very limited, he is very fond of the home care and feels safe with the healthcare staff. When a member of the hospital’s staff found that Frank developed a pressure sore, Frank opted to remain being treated from the security and comfort of his home, since he found being hospitalized to be very stressful.
Liz is 50 years old, and was recently screened for breast cancer, which showed the presence of a tumor. And while she underwent a surgical procedure, she must continue with radio and chemotherapy treatments. While recovering at her home, a visiting nurse discovered a wound that had developed in the cicatrix from Liz’s operation. While a specialist has been recommended to consult Liz’s condition, the road to the nearest out-patient clinic is very long, and severe winter weather makes it difficult to even get there.
Expediting collaboration, assessment though a “web-based wound record”
One of the local visiting nurses with wound care expertise visits Frank at the care home and uses her smart phone to take images of the pressure sore. The images are then sent to a doctor at the hospital via a web-based wound record. The record is also used for planning Frank’s course of treatment, including the use of antibiotic, bandage, and pain management. The visiting nurse then carries out the treatment. This transfer of images and planning of treatment take place at least once a week until the pressure sore has healed.
As a result of the distance and weather conditions, Liz’s specialist began taking images of the wound with her phone and sent them to the web-based wound record. At the home care center, the image was assessed by one of the visiting nurse’s colleagues with wound expertise. After collaboration with Liz’ General Practitioner, who also has access to the wound record, the nurse with wound expertise then planned the treatment plan for Liz’ wound.
During subsequent visits to Liz, the specialist uploaded images of the healing wound along with a note to the wound record. The image and the note were examined by the doctor at the outpatient clinic, who in return uploads recommendations for the future treatment. Liz was offered access to the wound record herself, and if she was at any time worried about her cicatrix, she could use her own smart phone to take an image and upload it to the record, where she could also write notes. Due to the help of this focused treatment and the cross-sectorial communication, the wound in question has healed, and Liz can continue with her therapy.
Outcome of the Telehealth intervention
Both patients have enjoyed how the non-intrusive technology has improved the care they have received, and by seeing the images of his pressure sore, they and their relatives were able to get a better understanding of the pain both patients have felt, and the restrictions they experienced during their treatment.
For further information
Jane Clemensen and Aske Denning, MedCom
Else Sværke Henriksen, Municipality of Guldborgsund
(March 2011)
