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ePoster Presentations

EP-114 - Expert Outpatient Burn Care in the Home Through Mobile Health Technology

Sunday, April 29
4:25 PM - 4:40 PM
Location: Education Zone, Booth 2416, Screen 2

In the United States, approximately 450,000-500,000 patients sustain burns requiring medical treatment every year, with nearly 10 million world-wide. Ninety percent of burns are treated primarily in the outpatient setting. Burns are uniquely suited to the use of telemedicine because burn wound assessment is primarily a visual skill. Evaluation of key burn characteristics, such as percent total body surface area (%TBSA) and burn depth, using both store-and-forward digital imaging and videoconferencing, is comparable to standard wound examination. Unfortunately, despite adequate feasibility data, clinical studies demonstrating a benefit of telemedicine in clinical burn care outcomes are lacking. Higher quality research is desired.

At the Medical University of South Carolina Children's Hospital Pediatric Burn Program, we have designed, developed, deployed and trialed a novel smartphone application (TeleBurn app) to treat partial thickness burns in the outpatient setting. The app allows the provision of tertiary clinical burn care directly in the patient's home through store-and-forward pictures, text messaging, video conferencing, educational videos, and frequently asked questions (FAQs). After IRB approval, we retrospectively reviewed clinical outcomes and feasibility data in pediatric burn patients with partial thickness burns. A comparative study was performed between a cohort of patients offered the TeleBurn app with standard therapy (APP) compared to a similar cohort of patients burns treated with standard therapy alone (ST). Clinical burn care was provided to 32 patients via the APP and 25 patients with ST in patients with partial thickness burns treated with advanced burn dressings on an outpatient basis, such as Mepital AG ™ and Biobrane™. In the APP cohort, feasibility data demonstrated that 74% of patients and families used the app, with 26% refusing, in 14 counties in South Carolina, with more than 50% usage across all major ethnic groups. There were no burn wound infections or unexpected return to clinic or the emergent department. For the APP group, a total of 239 burn store-and-forward pictures (mean, range: 6, 0-34) were sent. 529 messages were sent between burn expert provider and the patient/family, with a range of 0-162. Four patients utilized the video calls (11%). The burn dressing change tutorial videos were accessed by the 32 patients a total of 155 times (4.2, 0-10). The FAQ page was accessed by the 32 patients a total of 120 times, range: 0-14. In comparing APP to ST groups, the populations had similar burn characteristics, with the mean %TBSA in the APP cohort of 4% (range: 1-16% ) vs 6% (range:1-15%) in the ST group (p=0.75) .The time to burn healing in days was similar between groups (APP vs ST, (mean±SD, range) 12.6±5.7, 6-25 vs 11.6±4.7, 5-22, (p=0.9). The mean number of in-person clinical encounters was 3.3 versus 0.93 (p=0.03).

This project describes a functional, tested, scalable TeleBurn app in clinical use in a pediatric burn program in South Carolina. Further prospective, randomized study may validate home-based clinical burn care via mobile technologies, improving access to expert burn care to a vulnerable population.

Learning Objectives:

Aaron Lesher

Assistant Professor of Surgery and Pediatrics
Medical University of south Carolina

Dr. Lesher received his MD degree in 2006 from Duke University School of Medicine. He then completed his internship and general surgery residency at the Medical University of South Carolina. Dr. Lesher then went on to fellowship training in pediatric general and thoracic surgery at University of Tennessee Health Sciences Center/LeBonheur Children’s hospital, finishing in 2014. During that time, he obtained expertise in trauma and burn injuries in children. He is board certified in General Surgery and board-eligible in Pediatric General Surgery.
Since returning to the Medical University of South Carolina (MUSC) as an Assistant Professor in Surgery and Pediatrics, he has pursued his interests in telemedicine. He has focused his clinical and research interests in outpatient provision of care through telehealth, and is the medical director for the Virtual Consultation Clinical at the Center for Telehealth at MUSC. He also has a special interest in the care of burn injury in children and has developed a comprehensive burn telemedicine program at MUSC Children’s Hospital this year.

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