“It has the potential of revolutizing how home health care patients are assessed,” said Liz Tolchard, acting manager of Home Health Care, Maple Ridge, BC, where new computerized imaging technology is being clinically tested. Tolchard is referring to an innovation that partners a tiny digital camera and laptop computer that could become standard equipment among the bandages and wound care ointments in the home health nurses’ care kits. The system allows nurses to capture photographic images of chronic wounds and instantly transmit them to specialists for assessment and advice on care.
Developed by Dr. Jonathan Burns, an emergency room doctor at Matsqui-Sumas-Abbotsford (MSA) Hospital and the hospital’s IT networks Chief, the device called Pixalere is intended to speed up the assessment process thereby reducing the hospital visits for a patient. It’s said “necessity is the mother of invention” and with this initiative Dr. Burns stresses that was indeed the case. “A woman was coming into emergency repeatedly one weekend for me to assess and change the dressing on a second-degree burn, and I thought there had to be a better way to provide her care,” he said.
“Home-care nursing is an isolating experience and this new technology would allow nurses access to consultation that they otherwise wouldn’t have on the job,” said Pat Light, Chilliwack Health Services Administrator, Fraser Health Authority. “It also looks at the difficulty many clients face in having to make long journeys into the Vancouver Wound Clinic for assessment, addressing the issue of access which is key in these evolving times of health care.”
Five Maple Ridge home health nurses are using the system in a clinical trial that got underway in early October. Project coordinator Laura Case developed the specifications for the clinical trial of the product that involves nurse evaluation of the system to determine user friendliness of the camera and the overall effectiveness of the equipment. The nurses are also working with clinical resource nurses and the Vancouver Wound Clinic to evaluate the quality of the photos and how possible it is to accurately assess the wound status from the photos.
Potential benefits of this technology reach beyond direct patient care to developing a database for future referencing. “A picture is worth a thousand words,” Tolchard said, explaining a visual image is a more optimal way to document a case compared to a written subjective description. “We’re always looking for cost-effective ways to manage chronic wounds and this technology has provoked a lot of thought around traditional methods in home health.”
Wound care is a very common health care need, according to Tolchard, pointing to the number of diseases that cause skin breakdown, such as diabetes and vascular impairment. In Fraser Health in the past year alone, there were 190,295 home care visits, with 43 per cent of dealing with wound care.
“Ultimately this is very good news for wound clients,” said Amanda Burns, a Maple Ridge home health nurse who happens to be Dr. Burns’ sister. “It provides greater access to care and this is extremely significant for the frail elderly.
“The clients are the ones who live with the realities of how long chronic wounds take to heal, and they are very excited about the possibilities,” she added. “On average it could take a couple of months for healing and if we can shorten that by even half by bringing the specialized knowledge to the patient at home, then we have accomplished a lot,” Burns added.