healing time and positive consumer feedback". This quote, from the article results, is a good introduction to the tone of the article.  After reading the article, please let us know your thoughts and concerns regarding this topic ?

healing time and positive consumer feedback” seems to conclude that current research indicates the effectiveness of telehealth in treating wounds.  However, upon reading the table in the article regarding each individual study, I am not sure the studies support full scale telemedicine in wound care as an effective alternative to physical examination.  Perhaps with appropriate resources telemedicine can be effective, however, the resources seem to be an absolute necessity for effective treatment.  As the article notes, dressing a wound may require skills beyond what a patient has, and there may not be an additional caregiver who is capable of assisting.  Additionally, a virtual visit does not allow the clinician to fully evaluate a wound the way an in person examination does.  The severity of the wound may not be fully acknowledged, which can prevent an effective treatment plan, delaying or otherwise negatively affecting the healing process.  Telemedicine may have a role in wound care, for an appropriate patient who has the necessary resources.  However, to conclude that wound care will be just as effective for every patient would be too broad of a conclusion.  

which gave way for the different disciplines to communicate different aspects of treatment. Where this thrives in the pandemic scene is less likelihood of ending up with no care at all and better yet, not being exposed to potential COVID-19 infection. To conclude, this method of care is currently at a very basic level, but the pandemic has given an opportunity to change the medical field forever from optimizing this technology. One day patients might rarely receive care in person, that is scary to think about but there is always the lingering possibility.

The authors brought up the fact that it is important for patients to be able to effectively communicate their wound symptoms with the clinician.  This makes sense, as most information gathered during a telehealth session comes from discussion with the patient, rather than from physically examining the patient.  This poses a challenge in communities with low health literacy because the patient may lack the vocabulary and knowledge to be able to thoroughly describe their wounds to the clinician.  This highlights the importance of the clinician being able to ask the right questions as well as the clinician’s ability to accurately observe a wound via photos and video calls.  Additionally, I would be concerned about patients in lower socioeconomic areas having access to clean and safe spaces to administer their own wound care.

A line from the paper that stood out to me was: “there is currently a lack of validity and reliability regarding the use of telehealth and/or static images to assess and treat chronic wounds within organizations that do not already have an established telehealth system.”  Because of this, I think it is too soon to draw conclusions about the effectiveness of telehealth delivered wound care treatment.  However, it is good to read that there has been some success that healthcare systems can continue to build upon in the future.  

I found the article in question to be very eye-opening as I had never thought of the impact COVID-19 would have had on wound-care patients. Now knowing all the procedures and clinical intervention that is necessary in some cases, I cannot even begin to imagine how medical professionals had to adapt when treating these patients. The practices in wound care often involve dressing changes, applying medications, and even debridement multiple times a week at minimum. The idea of attempting to guide a family member or a nurse through these interventions over the phone seems like it would be overwhelming at the very least. I agree that having an experienced medical professional take the place of an inexperienced family member or nurse would be very beneficial and much safer. 

As for utilizing telehealth in the future, I feel that in certain situations, it could be a very helpful tool. For example, using telehealth could reassure a patient that they are in fact caring for their wound properly after being sent home from the clinic/hospital. However, I believe that using telehealth with patients who are still in the acute stages of healing could be potentially dangerous. Experiencing a wound in-person is much different than over the phone and most likely gives more insight into a patient’s overall condition. 

 As the article states physical examination is required in majority of wound care so telehealth is not possible for physical examinations. The article also states that patients will have to perform their own wound care which can lead to a lot of errors. I would not feel comfortable giving verbal instructions to a patient on how to proper treat and close their wound. They could have a nurse with them but I would still feel more comfortable being able to treat my patient myself since it is my responsibility to treat them properly. There are appropriate areas of health that is proper for telehealth but I feel wound care is not one.

A benefit of telehealth is lowered stress levels from not having to travel, especially if the patient is already anxious about the pandemic or logistics that come with traveling to a clinic. It also provides access to care that a patient might not otherwise have, as well as interpersonal interaction they might otherwise be lacking, which can lower stress and depression levels. While telehealth might not be optimal in the case of wound care, it can have its merits if the alternative is no care at all. However, when possible, wound care should optimally be done in person.

So with that said, what do we do regarding patients with chronic wounds who were affected by the stay at home orders put in place due to Covid. According to the article, a guideline

was developed to support clinicians who had to decide where telehealth can be an appropriate substitute for a face-to-face review. But the authors still feel that evaluation of patient outcomes, experience, and staff feedback are required to assess the tool's reliability in determining patient suitability for telehealth. The determination from this article wasn’t to say that telehealth has no place in chronic wound care. With the current development of telehealth and guidelines, we can provide a baseline for ongoing expansion within telehealth and it can prove to be an important tool for wound management in the future.

How reliant can we be on the client to be as compliant as possible? The article states, “the current model implemented as part of the emergency response relies on a patient's ability to discuss their wound and symptoms with the clinician remotely without the use of a clinical liaison, to decrease close contact and movement outside the home.” It's clear to see that things can go south in this situation. There are many aspects into analyzing wounds that can really only be done right with a health care provider such as depth, length, width and measurement of the wound. How confident can patients be to clearly communicate their wound to their healthcare provider? This lack of communication is probably faced by many healthcare providers across the world. At the moment in time, telehealth is  a great supplement to health care but isn’t advanced enough to be a primary source of treating patients.