WoComm: Managing Complex Wounds at Home Utilizing Telemedicine

Telemedicine has been shown as a feasible way to improve access to a wound expert, while not negatively impacting the quality of care provided to a patient. While multiple forms of telemedicine exist, videoconferencing provides real time assessment and allows for a WOC nurse to recommend changes to the treatment plan in a timely manner. WoComm is a wound telemedicine program implemented at a large home health care agency located in central Virginia. The purpose of WoComm is to improve access to a WOC nurse for rural, homebound patients through teleconferencing. The goal of WoComm is to reduce rehospitalizations and emergency room visits related to wound deterioration, provide an expert visit to rural patients admitted to home health with a qualifying wound, and to increase WOC nurse productivity. Patients with an open, non-healing surgical wound, ulcer of the legs or feet, or a pressure ulcer, were eligible for WoComm. Initial program evaluation took place between June 2014 and June 2015. During this time, 64 unique patients were eligible and 18 were enrolled, 38 visits were attempted and 19 visits were successful. Rehospitalizations and emergency room visits related to wound deterioration decreased as a result of WoComm. No significant difference was found in clinical or financial outcomes between each group of patients. Multiple barriers were identified to implementation including: equipment failure, patient refusal, and coordination issues. WoComm did not significantly impact WOC nurse productivity. While multiple barriers to implementation were identified, participating nurses perceived WoComm to be a positive influence on care, and WoComm has impacted important patient outcomes. Further investigation into the barriers of implementing new technologies in the management of wounds in the home health population is needed to aid in the development of efficient home health wound management programs.