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Outcomes of Telehealth for Wound Care: A Scoping Review
Carol T Kostovich1, Bella Etingen, Marissa Wirth
1Carol T. Kostovich, PhD, RN, CHSE, is Research Health Scientist, Edward Hines, Jr. VA Hospital, Hines, IL; and Associate Professor, Assistant Dean of Innovative Educational Strategies, Marcella Niehoff School of Nursing, Loyola University, Chicago, IL. At the Hines VA Hospital, Bella Etingen, PhD, is Research Health Scientist, Center of Innovation for Complex Chronic Healthcare; Marissa Wirth, MPH, is Research Health Science Specialist; Jamie Patrianakos, MA, is Research Health Science Specialist; and Rebecca Kartje, MD, MS, is Analyst. Mona Baharestani, PhD, APN, CWON, FACCWS, is Associate Chief, Wound Care & Research, James H. Quillen VAMC, Johnson City (Mountain Home), Johnson City, TN. Frances M. Weaver, PhD, is Research Health Scientist, Hines VA Hospital, and Professor, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL. Acknowledgment: This work was supported by the US Department of Veterans Affairs, Diffusion of Excellence Office, and Office of Research and Development, Health Services Research and Development Service, Quality Enhancement Research Initiative Program (PEC 19-310). Disclaimer: The views expressed in this article are those of the authors and do not necessarily represent the views, position, or policy of the Department of Veterans Affairs or the US Government. The authors have disclosed no other financial relationships related to this article. Submitted June 8, 2021; accepted in revised form July 23, 2021; published online ahead of print February 14, 2022.
Objective:
To synthesize the literature on delivering wound care via telehealth and compare clinical, healthcare utilization, and cost outcomes when wound care is provided via telehealth (telewound) modalities compared with in-person care.
Data Sources:
An electronic search of PubMed, CINAHL, and Cochrane Clinical Trials databases for articles published from 1999 to 2019 was conducted using the following MeSH search terms: telewound, wound, wound care, remote care, telehealth, telemedicine, eHealth, mobile health, pressure injury, and ulcer.
Study Selection:
Articles were included if they were a scientific report of a single study; evaluated a telehealth method; identified the type of wound of focus; and provided data on clinical, healthcare utilization, or cost outcomes of telewound care. In total, 26 articles met these criteria.
Data Extraction:
Data were extracted and grouped into 13 categories, including study design, wound type, telehealth modality, treatment intervention, and outcomes measured, among others.
Data Synthesis:
Of the 26 studies, 19 reported on clinical outcomes including overall healing and healing time; 17 studies reported on healthcare utilization including hospitalizations and length of stay; and 12 studies reported costs.
Conclusions:
Evidence regarding the use of telewound care is weak, and findings related to the impact of telewound care on outcomes are inconsistent but indicate that it is not inferior to in-person care. Greater use of telehealth as a result of the COVID-19 pandemic points to further development of navigation and education models of telehealth for wound care. However, additional studies using rigorous research design and leveraging robust sample sizes are needed to demonstrate value.
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