Telemedicine in a Rural Community Hospital for Remote Wound Care Consultations

BACKGROUND: We found that the number of patients requiring wound care consultation was increasing but the distance from our rural campus to the main campus acted as a barrier for timely consultations. Therefore, we implanted a telemedicine program, based on technology manufactured by VISICU (Baltimore, MD) used by intensive care and step-down unit patients in our health system. PROCESS: A wound consultation was performed with one certified WOC nurse in the remote facility and another certified WOC nurse at the patient's bedside to establish method reliability. Following this assessment of feasibility, we initiated a formal program for remote wound care consultations in March 2009. Fifty remote wound consults have been completed, resulting in an estimated savings of 5000. CONCLUSIONS: Limited evidence supports telemedicine for remote wound consultations; most literature is based on use of digital camera images or Web cam/computer programs. Our program uses a unique, real-time technology for remote wound care consultations. The potential cost-savings related to decrease in complications of wounds and the positive effects on patient progression and length of stay have not yet been measured. However, our initial experiences suggest that remote consultations using real-time telemedicine reduce delay between request for consultations and its completion, diminish transportation and nonproductive staff time costs, and are comparable to traditional face-to-face consultations.