The Covid 19 Pandemic Pushes The Use Of Telemedicine In Wound Care Centers

COVID 19 has impacted every aspect of our lives and “Stay Home- Stay Healthy” state or local orders confine many of us to our homes. However, there are some people that must still be seen by their provider on a regular basis.  Wound care patients are unique in that they are often very ill with multiple underlying conditions causing their wounds not to heal.  They therefore still need access to expert services at a specialty center.  Deciding on how to best service them, where to service them and by whom has been a challenge.

The Association for the Advancement of Wound Care and the Alliance of Wound Care Stakeholders have made it easier to navigate through the ethical questions that are raised when one determines who should be seen in the traditional wound care center and who is better off staying home during this pandemic. Comprehensive’s guidance to its wound care center clients has been to see complex patients at their clinic to manage the most challenging wounds particularly those who are at risk for amputation, hospital admission, or infection.  Providing services to these patients will improve outcomes but also help mitigate over-use of the emergency department, surgery centers, hospital inpatient units so we preserve those resources for COVID 19 patients.  With those high-risk patients, the goal may change from “heal as fast as you can at all costs” to the prevention of hospitalization.

It does not mean the wound care center does not offer care to the patients that are asked to stay home and follow a “Stay Home-Stay Healthy” local order. They can receive a virtual health check by phone, an E-visit, or participate in a telehealth visit so the team stays connected and offers remote wound care. Dressings can be sent to the home if there is someone in the household who can be taught how to apply them.  Many patients and their family members have Smart Phones and can easily show their wound to a clinician if there is a good light source.

Medicare and many private insurance companies have agreed to pay the professional fee for telemedicine visits.  The Association for Wound Care Stakeholders has opened a dialogue with the Center for Medicare Services (CMS) to consider also paying the facility fee.  After all, hospitals still must staff their outpatient wound care clinic and keep the lights on while people connect via the internet.

Will telemedicine be a source of care once we have a vaccine and can test for COVID 19?  We believe it will!