According to a feasibility study, Dermatologists can consult on wound care via cell phone, improving the quality of care and reduce costs. "Leg ulcers are an important cost factor in health care systems," write Ralph Peter Braun, MD, from University Hospital Geneva in Switzerland, and colleagues. "It has been shown that a telemedical wound care consultation can improve quality of care and help reduce costs."
Three physicians separately evaluated 61 leg ulcers for epithelialization, fibrin, necrosis, and granulation tissue at the center and normal border, erythema, cyanosis, eczema, and hyperpigmentation at the periphery. The gold standard was the face-to-face consultation performed by one physician, and the other two physicians performed the remote evaluation using a new generation of mobile telephones with integrated cameras. The image obtained with the mobile telephone was immediately transmitted via e-mail.
Cohen kappa statistics revealed that the agreement between the remote and face-to-face evaluations was very good, with kappa values of up to 0.94. Image quality was thought to be good in 36 cases (59%) and very good in 12 cases (20%). In 50 cases (82%), the dermatologists felt comfortable making a diagnosis based on the images.
"Although this study was performed with the first generation of these devices, we were able to demonstrate the feasibility of such a telemedical wound care consultation," the authors write. "We had the impression that a high percentage of the problems related to leg ulcers could be solved with this type of teleconsultation. The transport of the patient to the hospital or the physician’s office could be replaced, and this approach could potentially save the health care system money."
Arch Dermatol. 2005;141:254-258
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