Abstract
Introduction
In 2014, a multidisciplinary burn telemedicine program was developed in order to increase access of burn specialists and improve care. This proved to be beneficial in the face of the pandemic through utilization of existing programs and development of new processes.
Methods
The basis of this burn telemedicine program utilizes a partnership approach. Visit types include inpatient and outpatient consultation, with visits occurring in in-patient settings, emergency departments, out-patient clinics, and in patient’s homes. During the COVID 19 pandemic, a weekly meeting was held with telemedicine program and clinic leadership, program coordinators, and our burn surgeon to triage patients to telemedicine or inpatient visit types. This often required the nursing staff to contact the patients to obtain more information about the injury and help them to securely upload photographs. The telemedicine visits were primarily video visits occurring either in clinic settings or the patient’s home. The burn psychotherapist and occupational therapists also utilized telemedicine for patient care. In addition, aftercare support groups, which originally were held twice each month onsite, transitioned to video and increased to three times. Telemedicine is also being utilized for school re-entry programming and the annual burn camps. The program is also tracking reimbursement for telemedicine activities.
Results
The pandemic resulted in a significant increase of telemedicine visits as compared to in person clinic visits often occurring directly into the patient’s homes. A greater number of burn patients were seen overall than previous to this process. Attached graphs show the comparison of in person visits compared to telemedicine visits during this time frame. Additional data will be presented showing the breakdown of visit location, provider (psychotherapist versus surgeon for example), and usage with aftercare programming.
Conclusions
This telemedicine program with established processes and partnerships, allowed transitioning alternative care due to the pandemic to be less stressful event. Benefits to patient care included the ability of the multidisciplinary burn team to see more patients safely via video especially in their own homes and allowed continuation and expansion of aftercare support. Challenges experienced included needing additional staff to ensure patients were triaged appropriately, scheduling of visits, and technology training for patients and families, and to ensure that patients were receiving medications and dressings as needed. The increased volume of patients seen could be attributed to more frequent visits and an increased volume of burn injuries.