NP Medical News about telehealth; chronic wound care system

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Challenges faced in implementation of a telehealth enabled chronic wound care system
Rural and Remote Health, 08/25/09

Barrett M et al. – During the trial 12 sites had the relevant software installed and were able to access a central server. Although a total of 41 patients with chronic wounds were enrolled, four sites did not enroll any patients and only two sites successfully incorporated the system into regular practice. Major obstacles were workforce issues and significant delays in installing the software at some sites. Only 47% of the healthcare providers trained to use the software at the beginning of the trial were still employed when the trial ended. Prolonged periods of vacant positions at one remote clinic and an aged care facility made it impossible for the remaining providers to allocate time for using the wound care software. The disease burden of the patient group, funding models and workforce shortages frustrated the successful adoption of an evidence based strategy that was known to improve health outcomes.

Exclusive Author Commentary
Melissa Barrett, 08/26/09

The intention of this study was to test the factors involved in the role out of a telehealth wound care application. The results were discouraging. A number of factors, but principally workforce shortages, meant that only one site was able to fully adopt the new system. Other factors involved lack of autonomy to make decisions related to IT systems and problems with funding models that did not compensate providers for wound care management. The authors conclusions are that eHealth measures have excellent potential to save needless suffering in rural and remote settings , but that some of the fundamental weaknesses of rural health services impede these processes. This article aims to highlight these issues and provide recommendations to assist future telehealth applications

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