A new app called WoundCare is successfully allowing patients to remotely send images of their surgical wounds for monitoring by nurses by using smartphones. The app was developed at the Wisconsin Institute of Surgical Outcomes Research with the goal in mind of earlier detection of possible surgical site infections and the possibility of preventing hospital readmissions as published in the Journal of the American College of Surgeons.
Surgical site infections are one of the most common hospital acquired infections and the leading cause of hospital readmissions following surgery. Due to the prevalence of surgical site infections the research team decided to see if monitoring the wound postoperative could be effectively achieved by having patients upload photos using an app, and enable a few brief questions and answer in order to gather information that might not easily be captured and portrayed in the images.
Patients typically are not able to identify infections or the signs of cellulitis and other wound complications, leading to patients returning for a scheduled routine appointment that requires readmission that may even include needing further surgery, that may have been avoided with outpatient management via WoundCare which would allow for the intervention at an earlier time.
40 vascular surgery patients were enrolled to conduct this study. Overall data submission rate was 90.2% among the participants, with their submissions being reviewed within an average of 9.7 hours. During the course of this study 7 wound complications were detected and 1 false negative was found through using the app.
Participants reported feeling at ease with the use of the app and felt reassurance at having their wounds monitored regularly. Nurse practitioners responsible for the viewings attested to the value of this program, however they noted it was difficult to find the time to do so on top of an already heavy workload. It is noted that the successfulness of this program and the sustainability of it requires a dedicated transitional program, not just adding the task to the staffs current often very busy workload
This protocol has the potential of cost saving components in addition to patient satisfaction and safety aspects. Surgical site infections are one of the most expensive hospital acquired infections costing on average upwards of $30,000 per each wound related readmission and an estimated $3-10 billion annually. Those savings alone could provide relief to hospitals cost on the healthcare system.
Limitation to telemedical protocols are that not every person has a smartphone or knows how to use one. The team provided participants learning how to use a device that was tailored to using the WoundCheck app and provided each patient with a smartphone and guide for their use while participating in the program study. Many of the participants were older adults with no knowledge of how to use this technology, but this study demonstrated these high risk patients are able to complete this protocol with high fidelity and satisfaction. This model is easily adaptable to other medical centers according to the researchers.
