Chronic wounds consultation by telemedicine between a rehabilitation health care center and nursing home or home.
Mrs Amélie CHOPINa, Mrs Andrée Alice ALLAINa, Dr Marie-Christine CRISTINAb, Dr Claire LE MEURc, Dr Benoit NICOLASc, Dr Philippe GALLIENc, Dr Sandrine ROBINEAUc
a Pôle MPR Saint Hélier, b Pole saint hélier, c Pole St Helier
Saint Helier Rehabilitation Center (Pole MPR Saint Hélier), located in Rennes, has been selected for a regional telemedicine project in 2014 about chronic wounds.
Aim. To make care access easier for heavy disabilities patients in nursing homes or at home with chronic wounds.
Method. The members of TLM Pl@ies chronic team are specialist doctors and nurses for wounds. On request, the occupational therapist or dietician involve in the consultation (multidisciplinary approach). A secure videoconference (web) is used.Results.
Results. Since july 2014, over 100 teleconsultations have been done. Targeted population is constituted by patients:
- whose access to care is decreased due to moving difficulties,
- of which the health care team is crossing difficulties in the care process (wound care but also disability, nutrition ...).
70% of requests come from the nursing home, 30% from homes (pressure ulcers stages 3 and 4, arterial ulcers, venous or mixed). Middle Age 78 years (20-101 years). Only 3 patients refused. Time to organize the teleconsultation is on average 13 days. Consultations last on average 25 minutes. In 30% of cases the teleconsultation is extended by a real live training time for the nurse at home guided by the TLM Pl@ies chroniques team. We evaluate professional satisfaction and technical satisfaction. Without teleconsultation, in 77% of cases transportation request for consultation would be made, in 5% hospitalization. In 18% no request would be done.
Discussion/Conclusion. These first results, encouraging, confirms the interest of specialized consultations in medico-social settings, and telemedicine can be an effective solution.
Keywords : telemedicine, pressure ulcer, chronic wound, nursing home, disability, care access, elderly