The impact of telemedicine on outcomes of chronic wounds in the home care setting.

Since 1997, more than 2,700 home care agencies have closed due to changes in reimbursement. With the implementation of a prospective payment system, there is concern--not only regarding the survival of the remaining home care agencies, but also whether adequate care can be provided to the patient. Chronic wound care is both prevalent and costly in home care. Factors contributing to cost include inconsistency of wound assessment and documentation and low usage of advanced wound products. These factors lead to lengthened healing time, more frequent visits by practitioners, and low healing rates. Involving a wound specialist can improve patient outcomes while decreasing cost. The authors examined the utilization of telemedicine in situations where wound specialists consulted with the home health nurse in the patient's home regarding care of chronic wounds. During the two-way video visit, the wound specialist assessed the patient and the wounds and made recommendations for treatment. The wound specialist also collected outcome data during the visits. This data was then compared with like data collected as a baseline prior to the telemedicine intervention. Results revealed improved healing rates, decreased healing time, decreased number of home health visits, and a decreased number of hospitalizations related to wound complications. Telemedicine was deemed a viable option for delivering quality, cost-effective care to chronic wound patients in the home care setting.