A pilot study of specialized nursing care for home health patients

We conducted a pilot study to assess the feasibility of remote (Web-based) consultations for leg wounds. The wounds were photographed by a home care nurse using a digital camera and the images were transmitted to a server from the nurses' office, together with patient details. The home care nurse graded the wounds and suggested a treatment plan. Subsequently, a specialist wound-care nurse also graded them and suggested a treatment plan, using the data stored on the Web server. Thirty-four patients were studied. The Web system proved simple to use and staff responses were positive. The agreement between the home care nurses and the specialist nurse in assessing wounds was good (kappa coefficients 0.41 to 0.71). Agreement over the treatment of wounds was more variable (kappa coefficients -0.75 to 0.81). The results of the pilot study are encouraging and suggest that Web-based communication can improve the quality of care for patients with leg wounds and reduce costs.