813 Burn Care in the Patient’s Home: Development of a Secure HIPPA Compliant Process to Share Photographs with the Provider

Introduction Burn Telemedicine programs are shown to improve care, increase access to specialists, provide real-time education, and reduce rates of missed outpatient visits. Many occur in acute care facilities or outpatient clinics and conducted with video technology. This center has expanded the depth of options for the care team to include a Burn Telemedicine Store and Forward Program. This program is unique in that patients receive an outpatient burn visit from their home. Methods Photographs instead of video are uploaded into the patient’s electronic medical record. The provider reviews the photographs then conducts a phone visit to review the plan of care and recommendations. This program is reserved for patients requiring outpatient evaluation and meet specific criteria including having technology available to upload photographs into the medical record, minor burns not requiring complex dressing changes, or burns located in areas needing range of motion evaluation. Burn telemedicine coordinators assist patients in creating access to their electronic medical record prior to discharge or during their initial clinic visit. Training relating to lighting, camera angles, and number of photos to include is performed. Photographs are uploaded into the medical record within a prescribed timeframe. The phone visit is then scheduled and conducted between the patient and provider. Results Benefits of this program include flexibility for patients to receive follow up care from their home, increased access to burn specialists in areas where healthcare facilities are scarce, and the ability to speak to their providers to review the care plan. Additionally, this program is beneficial to providers who have flexibility to review photographs and formulate the plan within the electronic medical record for this subset of patients instead of having them travel to a busy outpatient burn clinic. The providers bill the patient’s insurance for the phone visit. Finally, this process is fully secure and HIPPA compliant. Challenges have occurred within this program. The telemedicine coordinators have had to assist patients with limited experience with technology to upload photos into the electronic medical record which is time consuming and complex. In addition, some patients are not available during their scheduled phone visit time, resulting in additional time to reschedule their visits. Still this program has helped reduce the number of patients lost to follow up. Conclusions This program is a beneficial option for this subset of patients. Patients comment how much they appreciate the ability to do an outpatient appointment from their home. Applicability of Research to Practice This is applicable as it describes the benefits and challenges of developing a secure option for outpatient burn care. Outpatient visits directly into a patient’s home is unique and innovative.