Rationale / Objectives
Project/Program Description & Major Achievements
As there is an increase in the aging population, developing methods of clinically appropriate and cost-effective wound care is becoming more relevant. Through this study, telemedicine was found to manage pressure ulcers at a lower cost with better health outcomes for homebound patients.
For more information on wound care: Wound Care Overview
People / Organizations Involved
- Riley S. Rees, MD.
- Noura Bashshur, MHSA.
- University of Michigan Health System (UMHS)
- Telemedicine Resource Center and Department of Plastic Surgery
The cost of care for hospitalization for a pressure ulcer ranges from $5000 to $40,000. There are several factors that contribute to the high cost for the treatment of pressure ulcers including nursing time, physician time, surgical procedures - flags and debridement, and longer hospitalization for complications. Furthermore, in the US a quarter of home care referrals are for wounds.
The TeleWound program is a web-based transmission of digital photos and remote consultation to allow homebound patients to receive care from their plastic surgeon. The TeleWound nurses visit the patient's home to take a digital photo and assess the wound which is updated to the web-based platform for the physician to access.
The 19 patient controls were matched based on wound type, comorbidities, the distance of residence to the clinic. All care was received from the same surgeon. The use of service measures includes: ED visits, number of outpatient clinic visits, number of inpatient hospitalizations, length of stay, number of outpatient clinic contacts, and level of outpatient visit acuity. Financial performance was measured through hospital financial records.
Linked Article: Remote Wound Consultation
The telemedicine group had:
- 50% fewer emergency department visits than the control group
- less than 1 emergency department visits each, during the 2-year period of the study than the control
- there were 54% fewer days of hospitalization in the telemedicine group versus the control
Furthermore, average inpatient direct cots for established TeleWound patients declined from $18,047 to $1,572 from 2004 to 2005.