Telemedicine: A Bridge to Improved Burn Care for People Experiencing Homelessness? Provider and Allied Healthcare Professional Perspective on benefits and drawbacks in Long-Term Care

Abstract

BackgroundWith greater numbers of unhoused people in the US, there is an increased need to find ways of providing appropriate healthcare to this population. Burn injuries can be some of the most traumatic injuries, physically and mentally. With the possibility of lengthy recovery times and intense outpatient follow-up post hospitalization or ER visit, it is crucial that we find ways to support providers’ ability to provide care and for patients, especially unhoused patients. Telemedicine has rapidly expanded since the onset of COVID-19, yet it has not been often used to provide care to unhoused individuals. MethodsIn the study, semi-structured qualitative interviews were conducted to explore the advantages and disadvantages of using telemedicine with unhoused burn patients. Six interviews were conducted with providers and allied health professional from the UW Medicine Regional Burn Center at Harborview Medical Center in Seattle, WA. Interview data was analyzed and themes were identified using a constant comparative method. Participant recruitment was limitation of the study and additional interviews may have helped to achieve data saturation. Interview data was analyzed and themes were identified. ResultsThe study found that providers and allied health professionals at the UW Medicine Regional Burn Center at Harborview Medical Center are hopeful to use telemedicine with unhoused patients. Moreover, it was noted that technological barriers may affect patients’ ability to use telemedicine, but with the support of resource in the community this could be overcome. As it can be difficult to assess wounds via telemedicine, participants believed that telemedicine may not be appropriate for all burn injuries and that it could be used alongside in-person care. ConclusionAlthough there were concerns with using telemedicine with unhoused patients, most participants believed in the potential of telemedicine under specific conditions. Based on the findings, our recommendations for using telemedicine with unhoused burn patients included: 1. Using telemedicine primarily in the later stages of wound care. 2. Ensuring that there are ways to provide needed supplies to patients. 3. Involving community partners in the process. In particular to assist with resources and training in the use of telemedicine. 4. Using telemedicine to collaborate with providers in the community and larger region to support patients that may not be able to get to a Burn Center, yet need to be physically seen by a medical professional.