Wound and Reconstructive Service, Moses Cone Health System, Greensboro, North Carolina 27401, USA.
J Wound Ostomy Continence Nurs. 2011 May-Jun;38(3):301-4. doi: 10.1097/WON.0b013e3182164214.
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.
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.
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.
我们发现需要伤口护理咨询的患者数量正在增加,但我们的农村校园与主校区之间的距离成为了及时咨询的障碍。因此,我们植入了一个远程医疗项目,该项目基于我们医疗系统中重症监护和下病房患者使用的 VISICU(马里兰州巴尔的摩)制造的技术。
在远程设施中由一名认证的伤口护理护士和患者床边的另一名认证的伤口护理护士进行伤口咨询,以建立方法的可靠性。在对这种可行性进行评估后,我们于 2009 年 3 月启动了远程伤口护理咨询的正式项目。已经完成了 50 次远程伤口咨询,估计节省了 5000 美元。
远程伤口咨询的远程医疗的证据有限;大多数文献都是基于数字相机图像或网络摄像头/计算机程序的使用。我们的项目使用独特的实时技术进行远程伤口护理咨询。与伤口并发症的减少、对患者进展和住院时间的积极影响相关的潜在成本节约尚未得到衡量。然而,我们的初步经验表明,使用实时远程医疗进行远程咨询减少了咨询请求和完成之间的延迟,减少了运输和非生产性员工时间成本,并且与传统的面对面咨询相当。