A mHealth application for chronic wound care: findings of a user trial

Abstract

This paper reports on the findings of a user trial of a mHealth application for pressure ulcer (bedsore) documentation. Pressure ulcers are a leading iatrogenic cause of death in developed countries and significantly impact quality of life for those affected. Pressure ulcers will be an increasing public health concern as the population ages. Electronic information systems are being explored to improve consistency and accuracy of documentation, improve patient and caregiver experience and ultimately improve patient outcomes. A software application was developed for Android Smartphones and tablets and was trialed in a personal care home in Western Canada. The software application provides an electronic medical record for chronic wounds, replacing nurses' paper-based charting and is positioned for integration with facility's larger eHealth framework. The mHealth application offers three intended benefits over paper-based charting of chronic wounds, including: (1) the capacity for remote consultation (telehealth between facilities, practitioners, and/or remote communities), (2) data organization and analysis, including built-in alerts, automatically-generated text-based and graph-based wound histories including wound images, and (3) tutorial support for non-specialized caregivers. The user trial yielded insights regarding the software application's design and functionality in the clinical setting, and highlighted the key role of wound photographs in enhancing patient and caregiver experiences, enhancing communication between multiple healthcare professionals, and leveraging the software's telehealth capacities.

Figure 1

The Add Patient Screen.

Figure 2

The Patient Info Screen.

Figure 3

The Wound Graph screen plots all wound assessment scores on a graph. Tapping on line vertices (points) will display a thumbnail image of the photo taken for that assessment.

Figure 4

The Update Wound Assessment screen. We can select wounds by either using the cursor on the patient image, or by tapping the “Left” and “Right” buttons. Once a wound is selected, we may reassess the wound, view its history, compare the last two assessment forms, or view graphically view all of its assessment scores.

Figure 5

The top of the New Assessment screen. We have the choice of selecting either the PUSH or Bates-Jensen assessment tool to assess a pressure ulcer.

Figure 6

The New Assessment screen continued. A large list of treatments may be selected when the “Treatments” checkbox is checked. Recommendations may be provided when reassessing a wound.

Figure 7

The Wound History screen shows us every assessment recorded (including treatments list and photo) for a selected wound. We may also delete and revise individual assessments from this screen.

Figure 8

The Week-by-Week Comparison screen compares the last two assessments for a selected wound in more detail. It compares the score for every field in the two assessment forms.