Leg wounds can be accurately assessed using photographs taken at a patient's home

A pilot study has shown that leg wounds can be accurately assessed using photographs taken at a patient's home, adding one more example to a growing list of medical conditions that can be successfully monitored remotely.

The study, which will be published in the December 7 issue of the Journal of Telemedicine and Telecare, involved 34 home health patients with a leg wound as their primary diagnosis. Visiting nurses, who are not experts in wound care, took digital photographs of the wounds, then sent the images and other patient health information to an enterostomal therapy nurse (ETN), a specialist in wound care.

Using a quantitative survey instrument, the Medicare Outcome and Assessment Information Set or OASIS, investigators found that the home health care nurses and the ETN generally agreed in their assessments of the wounds, signifying that the digital images were accurately representing the wounds. However opinions about treatment options often diverged between the home health nurses and the ETN, suggesting that access to specialty wound care could ultimately improve clinical outcomes.

Lower extremity wounds are common among patients receiving home health care. ETNs already have trouble keeping pace with the demand for their services, and that demand will only increase as the population ages.

"This study is significant for several reasons," said Joseph Kvedar, M.D., director of Partners Telemedicine and president of the American Telemedicine Association.

"First, it demonstrates how it's possible, despite a shortage of ETNs, to get more patients quick access to the expertise of these wound specialists. And when it comes to wound care, the faster you treat a wound, the better the medical outcome. It is also one more example of how communication technologies are helping bring medical monitoring into the homes of patients, and in many cases improving outcomes while saving money."

Remote monitoring, used in patients suffering with everything from congestive heart failure to diabetes, has grown significantly in recent years, thanks to the shrinking size and cost of computer chips, the increasingly connected home environment and patients' growing comfort with technology and the Internet.

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