Prioritizing Patient-Centeredness as a Foundation of Telehealth Solutions to Maximize User-Friendliness and Patient Empowerment in Wound Care Telehealth

Telehealth has been shown to benefit patients with chronic wounds by enabling faster access to care,¹ decreasing transportation cost,² and improving healing rates.³ Telehealth also has been recognized as a vehicle to deliver knowledge to patients and promote shared decision-making.⁴ As telehealth adoption in wound care expands, it is critical that technologies assume a patient-centered approach to facilitate use and maximize engagement. Lack of user-friendliness has been identified as one of the barriers to digital technology use in chronic wound management.⁵

To address these obstacles, the authors aimed to upgrade an existing, wound care-specific telehealth software (TeleVisit Tool; Wound Reference, Inc., San Francisco, CA) to enhance user-friendliness, optimize patient-provider communication, and empower patients to achieve greater involvement in their care plan. Using Design Thinking methodology, patient-centered features were developed within a cloud-based, mobile-responsive, HIPAA-compliant telehealth module as follows:

• Existing limitations/future desires were identified through patient and clinician interviews.
• Central themes and potential solution pathways were defined and mapped.
• Patient-centered features were developed/tailored to the primary patient demographic.
• Features were refined following usability testing and feedback collection.

Several patient-centered features were designed and integrated to the existing telehealth software, including the following:

• Patient Portal, OpenNotes provision/21st Century Cures Act-compliant: Patients can request consultations/submit photos via secure text messaging, and access medical records with no downloads required.
• Real-time instructional tour of the video call waiting room: Patients can learn how to utilize all functionality of the software through a simple, graphic format.
• Digital customized patient education materials: Patients can receive wound care/product handouts via SMS/email; this feature meets an essential need for individualization and enables patients to gain greater agency in their healing process.

The existing telehealth software was successfully upgraded with features designed to enhance user-friendliness, optimize patient-provider communication, and empower patients to achieve greater involvement in their care plan.

References

1. Mahoney MF. Telehealth, telemedicine, and related technologic platforms: current practice and response to the COVID-19 pandemic. J Wound Ostomy Continence Nurs. 2020;47(5):439–444. doi:10.1097/WON.0000000000000694

2. Goff-Pronost ML, Mourgeon B, Blanchère J-P, Teot L Benateau H, Dompmartin A. Real-world clinical evaluation and costs of telemedicine for chronic wound management. Int J Technol Assess Health Care. 2018;34(6):567–575. doi:10.1017/S0266462318000685

3. Goh LJ, Zhu X. Effectiveness of telemedicine for distant wound care advice towards patient outcomes: systematic review and meta-analysis. Int Arch Nurs Health Care. 2017;3(2)3:070. doi:10.23937/2469-5823/1510070

4. Gethin G, Probst S, Stryja J, Christiansen N, Price P. Evidence for person-centred care in chronic wound care: a systematic review and recommendations for practice. J Wound Care. 2020;29(9):S1–S22. doi:10.12968/jowc.2020.29.Sup9b.S1

5. Foong HF, Kyaw BM, Upton Z, Car LT. Facilitators and barriers of using digital technology for the management of diabetic foot ulcers: a qualitative systematic review. Int Wound J. 2020;17(5):1266–1281. doi: https://doi.org/10.1111/iwj.13396