SWIFT* Telewound Care Canada Project: Digital solutions for addressing wound care remotely

Introduction: There are over 6.5 million North Americans living with chronic wounds that require ongoing wound care. In Canada, 30-50% of all health care involves a wound. Without proper, regular wound care, patients can quickly suffer from infection, hospitalization, amputation and even death. Many of these patients live in remote and rural areas with inconsistent access to healthcare. Remote wound care requires high resolution, scientifically calibrated images with sub-millimeter accuracy and intelligent lighting/colour calibration to adjust for various environmental factors.

Doctors often rely on visual assessments to determine the level of care needed for a chronic wound, and aspects of the healing process could be easily missed over the phone or a poor-quality video call. To address this challenge, the Michener Institute of Education at University Health Network was invited to participate along with five regional health systems, hospitals and home/community care providers in a pilot telewound project. Michener was responsible for conducting a program evaluation of the pilot phase in order to provide data for the purpose of dynamic decision making, adaptation and development of the project; and to foster engagement and collaboration among participants to ensure success of the project.

Methods: Data was collected from surveys and monthly meetings with participating organizations to capture a dynamic picture of the projects’ successes and potential challenges. The data was analyzed and contributed to adaptations as required. Following the completion of the study a final focus group was held to discuss successes and challenges experienced by the healthcare organizations involved. Results: Organizations worked together to solve challenges of digital and privacy concerns, patient and nurse recruitment, and delays due to COVID.

Success stories include: Rapid response to vulnerable homeless population and preventing emergency department visits and amputation in homeless persons and rapid wound healing of bilateral partial myectomy after intervention and app use.

Discussion: Participating organizations found great value for their patients able to access and use the app. Future research in phase 2 will focus on creation of education for practitioners and further refinement of the SWIFT* app based on feedback from patients, students and healthcare providers.