Sparing resources by using new organisations.

Abstract

Journal of Wound CareVol. 28, No. 5 EditorialFree AccessSparing resources by using new organisationsLuc TéotLuc TéotAss Prof Plastic and Reconstructive Surgery Montpellier University Hospital, President of the Société Française et Francophone des Plaies et CicatrisationsSearch for more papers by this authorLuc TéotPublished Online:8 May 2019https://doi.org/10.12968/jowc.2019.28.5.259AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail Modern technologies are expansive. A potential reason why so many patients suffer the persistence of open wounds for long periods of time, if health resources are limited. Sophisticated new technologies regularly emerge from medical device research, based on mechanical actions on the wound bed or on chemical interactions, some of which gain the highest level of evidence. These technologies increase the capacity of nurses and doctors to get the wound quickly out of and infected state, promote rapid granulation They can also open the way for non-surgical debridement, in complex wounds, to be performed by health professionals without such a specialist skill base. The high costs of these therapeutic options have to be balanced with the quick resolution of a complex wound. Certainly, reduction of amputation rate in diabetic foot ulcers (DFU) requires new technologies as well as quick action and the use of a multidisciplinary team.Contrarily new organisations are easy to develop and relatively cheap. Telemedicine has recently been shown to have the capacity to treat hard-to-heal wounds at home, even where a high level of expertise is required.1 The outcomes observed are equivalent to patients going back and forth to multiple clinics, yet this spares transportation costs, reduces the need for long waiting times before having access to an appropriate specialist. Thus, live exchanges with caregivers on the patient status in presence of the patient, looking at the surrounding home during teleconsultation, not possible during classical clinics, becomes a reality.Collecting large databases for clinical research opens a new era in wound management, the expectations are to save more tissue, thanks to expert decision making. Here and in other parts of Europe, Ministries of Health finance new organisations of care, based on centralised call centres giving advice to non-experts and driving patients towards the appropriate experts. Flat rate (a lump sum provided for a given period of care) may be a key element, encouraging health professionals to develop efficiency, with this method of payment.These models could be adapted to other pathologies such as the examination of pathological scars at distance teleclinics. Scars present with different clinical profiles in volume, colour and shape. The expertise to treat scars is also quite rare and should be more available. Live assessment can be carried out during video calls or using picture transmission, leading to adapted recommendations for scar treatment and healing.The choice of spending money on medical devices or in the development of new organisations is limited by health resources, which itself is defined by governmental decisions. In other words the health professionals decisions still have restricted possibilities. Our collective responsibility is to develop more efficient wound management, to spend money based upon expert recommendations and to spare money with optimised organisations. Telemedicine may act as the technology that allows us to do such. References 1 Téot L, Géri-Trial C, Lano J et al.. [Domoplaies: Coordination of complex wounds in telemedicine and functionalities.] [In French]. Revue francophone de cicatrisation 2017; 4:53–58 Crossref, Google Scholar FiguresReferencesRelatedDetails 2 May 2019Volume 28Issue 5ISSN (print): 0969-0700ISSN (online): 2052-2916 Metrics History Published online 8 May 2019 Published in print 2 May 2019 Information© MA Healthcare LimitedPDF download