Saagar Walia1, Dalton Wolfe1,2, David Keast1, Chester Ho3,4, Karen Ethans5,6, Scott Worley7,8, Colleen O'Connell7,8,9, Denise Hill3,10. 1. Parkwood Institute Research, Lawson Health Research Institute, London, Ontario, Canada. 2. University of Western Ontario, London, Ontario, Canada. 3. Alberta Health Services, Alberta, Canada. 4. Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. 5. Spinal Cord Rehabilitation Program, Winnipeg Health Sciences Centre, Winnipeg, Manitoba, Canada. 6. Department of Internal Medicine's Section of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada. 7. Stan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada. 8. Division of Physical Medicine & Rehabilitation, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. 9. Faculty of Kinesiology, University of New Brunswick, New Brunswick, Canada. 10. Division of Physical Medicine and Rehabilitation, University of Calgary, Calgary, Alberta, Canada.
Abstract
Background: Pressure injuries (PIs) represent a frequent, often preventable, secondary complication of spinal cord injury (SCI) with serious consequences to health, societal participation, and quality of life. Specialized knowledge and service delivery related to treatment and prevention are typically located within major health centers. Introduction: For persons with SCI living at home, it can be challenging to access specialized PI care. A telehealth approach could help mitigate this challenge. This multisite pilot investigation assessed the feasibility of integrating information technologies within the management of PIs. Materials and Methods: Each study site formed a specialized interdisciplinary care team that identified components of their standard clinical care pathway and examined how they could be integrated with study technologies. A monitoring system was utilized to enable patients and caregivers to exchange clinical information with the care team. Results: Clinician and patient focus groups were completed to identify facilitators and barriers for long-term implementation. Findings demonstrate that this method of service delivery is feasible but requires further development. Discussion: This model of care requires refinement to address technological, regulatory, and clinician acceptance barriers; however, increased access to these services has the potential for improving PI healing or prevention rates in comparison with those not able to access specialized services. Conclusions: This project demonstrates that PI treatment services can be delivered effectively through the internet. Future trials can investigate efficacy and cost-effectiveness of this model of care to inform sustained implementation.
Background: Pressure injuries (PIs) represent a frequent, often preventable, secondary complication of spinal cord injury (SCI) with serious consequences to health, societal participation, and quality of life. Specialized knowledge and service delivery related to treatment and prevention are typically located within major health centers. Introduction: For persons with SCI living at home, it can be challenging to access specialized PI care. A telehealth approach could help mitigate this challenge. This multisite pilot investigation assessed the feasibility of integrating information technologies within the management of PIs. Materials and Methods: Each study site formed a specialized interdisciplinary care team that identified components of their standard clinical care pathway and examined how they could be integrated with study technologies. A monitoring system was utilized to enable patients and caregivers to exchange clinical information with the care team. Results: Clinician and patient focus groups were completed to identify facilitators and barriers for long-term implementation. Findings demonstrate that this method of service delivery is feasible but requires further development. Discussion: This model of care requires refinement to address technological, regulatory, and clinician acceptance barriers; however, increased access to these services has the potential for improving PI healing or prevention rates in comparison with those not able to access specialized services. Conclusions: This project demonstrates that PI treatment services can be delivered effectively through the internet. Future trials can investigate efficacy and cost-effectiveness of this model of care to inform sustained implementation.
Entities:
Keywords:
home health monitoring; rehabilitation; telehealth; telemedicine