Remote Wound Care Consultation in a Rural Community Hospital using Telemedicine

Historically two Certified WOC Nurses have completed wound care consultations within our five-hospital health system at the bedside. The speed with which consults were completed to our rural hospital located 33 miles away has consistently been a challenge.  Distance and travel time has resulted in delays of up to 72 hours.  This purpose of this pilot study was to implement the use of a telemedicine program to provide wound care consultation from remote locations using virtual ICU technology.  Virtual ICU technology is already present in the ICU departments across our health system. Virtual ICU allows for real time consults with cameras and microphones located in ICU room.  The camera can zoom in and out to assess patients. Inter-rater reliability testing was performed and deemed acceptable by the two WOC Nurses.  The ICU in the rural hospital is not typically at capacity, which has allowed for medical surgical patients to be moved into the ICU for the remote WOC consult and returned to their room afterwards. The pilot study metrics included travel time and nonproductive salary time in a six-month period. From March–August 2009, 33 remote consults have been performed in the rural hospital with reduced mileage for travel resulting in $835.00 saved and 66 hours saved during nonproductive travel time.  The total savings during this 6 month pilot study has been $3,082.  Not only has this pilot been cost saving it has also helped expedite WOC consultations.  A beneficial unexpected outcome is the ability to educate staff nurses related to skin care recommendations during the consult.  Limitations to this pilot included the staff RN transition with patients from medical surgical unit to the ICU and the occasion when the ICU is unavailable.  Based on our successful results, remote wound consultation is now the standard method for WOC consultation at our rural hospital.