Using telehealth interventions to prevent pressure ulcers in newly injuredspinal cord injury patients post-discharge - Results from a pilot study

Objective: To determine which of three approaches to care produces the lowe st incidence of pressure ulcers, promotes the most effective care of sores that develop, and leads to the fewest hospitalizations in newly injured pat ients with spinal cord injury after discharge. Methods: Spinal cord injury patients (n = 12) were recruited for a teleheal th intervention after initial injury, and matched cases were recruited for telephone counseling and standard care groups. Patients were monitored for 6-8 months after discharge. Results: The video group had the greatest number of reported and identified pressure ulcers. Differences in health care utilization between the video and telephone telehealth groups were small. The standard care group reporte d the lowest number of pressure ulcers and lowest frequency of health care utilization. Substantial differences existed in employment rates before and after injury. The video group had the lowest pre-injury rate of employment and the highest post-injury rate of employment. Conclusions: Tracking pressure ulcer incidence, particularly stage I sores, is difficult. Self-report is likely to lead to substantial underreporting. Similarly, self-report on health care utilization over extended periods ma y lead to undercounting of encounters. Telehealth interventions appear to i mprove ulcer tracking and management of all ulcer occurrences. Video interv entions may affect outcomes, such as employment rates, which are not conven tionally measured.