Telemedicine is a concept and technology that has captured the imagination of every specialty in medicine: psychiatry, dermatology, and ophthalmology, to name a few. However, in the field of wound care and pressure ulcer treatment, there appears to be a paucity of literature on the subject. A recent survey found only a few reviews and clinical observations related specifically to wound care.
The term telemedicine derives from the Greek prefix "tele," meaning "at a distance," and medicine is a derivative of the Latin word "mederi," meaning healing. Telemedicine as a phrase was coined by Thomas Bird in the 1970s. It was used to describe a system where physicians examine distant patients through the use of telecommunications technologies. The European Commission's healthcare "telematics programme" defines telemedicine as "rapid access to shared and remote medical expertise by means of telecommunications and information technologies, no matter where the patient or relevant information is located." At the University of Pennsylvania Health System, we are utilizing patient monitoring in long-term acute-care hospitals to monitor critical functions, cardiorespiratory status, and other critical parameters via "tele presence."
In my view, communication technology is abundant. However, the harnessing of this technology to evaluate, diagnose, and treat patients with pressure ulcers and chronic wounds is not limited by our imagination, will, or investment capacity. The payers, regulators, and the legalities involved will limit the use of telemedicine until we provide efficacious evidence for common usage. In a world where patient satisfaction, clinical benchmarks, and outcomes are becoming paramount, a base of clinical and scientific evidence must exist to support the use of this technology in wound care.
To that end, I believe ample opportunity to support this technology does exist as evidenced by a 2008 report titled, "Patient Monitoring Systems to 2012-Market Research, Market Share, Market Size, Sales, Demand Forecast, Market Leaders, Company Profiles, Industry Trends." This report forecasts that the US demand for patient-monitoring systems will grow 5.9% annually through 2012. Growth in the equipment sector will be based on strength in remote monitors that transmit data via the Internet or telephone and in-home use devices. This study analyzes the $9 billion US patient-monitoring system industry, demonstrating my earlier point that our economic engine has the will to invest in this emerging field. I believe that we, as wound care practitioners, have a mandate to be ahead of the curve to demonstrate all the possibilities of utilizing technology in the pursuit of evidence-based, cost-effective, and accessible wound care for the patients we serve. In general, the healthcare industry has not yet embraced the full potential of the Internet and telemedicine. Embracing novel approaches to care that make use of the technology at our disposal can successfully augment face-to-face practitioner/patient interactions. And that can make our wound care practices more efficient, more effective, and more satisfying for all involved.
"The value of the Internet has been severely overestimated for the present, but severely underestimated over the next 10years."
-Microsoft founder Bill Gates
Richard "Sal" Salcido, MD
Selected References