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Background: Historically, the HC CWOCN would collaborate with the HC nurses on complex and non-progressing wound patients through email, phone calls or, in cases where the patient lived in the local area, traveled to the patient’s home for a shared visit with the assigned HC nurse. To receive homecare services, a patient must be home-bound and for some patients, arranging travel to a wound clinic for specialized care can be very challenging. Some of these patients decline wound clinic services because of the cost and difficulty.
Implementation Process: In January of 2017, a pilot began to provide TeleHealth consultations in the patient’s home using Skype® for Business. Patients targeted had non-progressing wounds or wounds requiring daily dressing changes, and significant challenges in transporting to a wound clinic. Once identified, the HC nurse facilitated scheduling the consult, and updating the treatment plan as directed by the TeleHealth Provider. The HC CWOCN also started utilizing the Skype for Business application to perform shared visits in real time.
Results: Homecare CWOCN shared visit costs and travel frequency were reduced by 89% and 66% respectively. Visits that were previously limited by geographic location have now been expanded to support all locations within the Healthcare System. Both patients in the Wound TeleHealth Provider pilot experienced accelerated healing and a decrease in cost of care.
Conclusions:
Patient wound healing was accelerated.
Patients express high satisfaction with Homecare Wound TH visits
Homecare CWOCN can increase patient visits, while reducing costs.
Collaboration between the HC nurse, Wound MD, and patient to build plan of care together is effective, efficient and builds trust.