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 â„¢ and Biobraneâ„¢. 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, (meanÂ±SD, range) 12.6Â±5.7, 6-25 vs 11.6Â±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.
- Define the role of telemedicine in the outpatient treatment of acute burn injury
- Describe the rationale for using telemedicine for the outpatient treatment of burn injury
- Understand the benefits of using a smartphone application for the direct provision of care to burn injured patients at home