Teleassessment compared with live assessment of pressure ulcers in a wound clinic: a pilot study

Abstract

Objective: To compare teleassessment of pressure ulcers in individuals with spinal cord injury in a simulated remote setting with in-person assessments in a wound clinic.

Design: Pressure ulcers were assessed using a 3-megapixel digital camera; images of each ulcer were forwarded to a laptop in a separate room. Nurses completed a medical history and wound database form. A plastic surgeon reviewed the images and database and completed a questionnaire concerning the "remote" teleassessment or teleconsultation. When needed, the plastic surgeon obtained additional information using live audio-video interaction with the participant or nurse. After the teleassessment was completed, the plastic surgeon then assessed the individual and wound live and completed the same questionnaire used for the teleassessment.

Setting: Wound clinic of a rehabilitation hospital.

Participants: Individuals with a spinal cord injury and 1 or more pressure ulcers who were seen for initial or follow-up evaluations.

Main outcome measures: Percentage of agreement for teleassessment versus live responses to 4 yes/no questions regarding the need to change wound management, satisfaction with teleassessment, need for referral, and need for additional information.

Main results: Seventeen individuals with 20 wounds were evaluated. The total percentage of agreement for teleassessment versus live decisions was 89% (80% to 95%). The highest percentages of agreement were for the need to change wound management and the need for referral (both 95%); the lowest percentages of agreement were for satisfaction with teleassessment for making treatment decisions (85%) and the need to obtain additional information (80%).

Conclusions: Teleassessment of pressure ulcers in individuals with a spinal cord injury using digital images and a standard database compared well with in-person assessment, which is similar to results reported for other pathologic conditions.