Project Tele Ulcer Care tests home treatment of diabetic foot ulcers with the objectives of enhancing the quality of ulcer treatment, of economising labour in hospitals and nursing and finally improving communication across sectors.

The project, running from 1 January 2010 to 31 March 2011, aims at providing a faster and better coordinated care for patients with diabetic foot ulcers, with the intention of reducing complications and hospitalisations. The long term objective is national implementation of tele-care.

By means of tele-care, the visiting nurse is able to communicate with a physician/medical specialist and transfer images by use of a web-based ulcer record and a cell phone with camera.

The project is financed by the PWT Fund (Public Welfare Technology) and is a pilot project based in the two regional municipalities of Zealand and Southern Denmark, including four local municipalities in each region.

The project's demonstration phase started as planned on 1October 2010 and the participating municipalities and hospitals are now testing tele-medical treatment of patients with diabetic foot ulcers. In the preceding successful phases of the project, collaboration was organized, cooperation agreements were made, an evaluation design was developed, the equipment was purchased and the involved health professionals were trained in the use of the Electronic Ulcer Record.

We now enjoy experiencing the demonstration of telemedicine in the regions of Southern Denmark and Zealand.

The Ambitions of the project are:

• To improve the quality of the treatment of patients;
• To enhance the patients' quality of life through a reduction in the time spent on waiting and commuting;
• To economise labour and reduce the consumption of resources in the municipalities and hospitals;
• To establish a direct, patient-centred cooperation between municipalities and hospitals;
• To enhance visiting nurses' job satisfaction through new tasks and competences.

Policy Context

Every third Dane suffers from one or more chronic diseases, and 80 % of public costs in health are spent on treatment of these. Diabetes is severely on the rise and diabetic foot ulcers often lead to reduced quality of life for the patients having to spend time in waiting rooms and on commuting back and forth between their homes and outpatient clinics. At worst, the ulcers can lead to amputation due to late or inadequate treatment.

Currently, telemedicine is an area of much political attention in Denmark, and this pilot project is an important step in gaining experiences before wider, national telemedicine-/tele-care programs are implemented.

Technology solution

Image transfer via ordinary cell phones with camera and a web-based ulcer record.

Main results, benefits and impacts

• Better life quality for patients;
• Economisation of labour and efficient use of expert resources;
• Improved communication between sectors;
• Better healing rate of ulcers;
• Fewer transport expenses for patients;
• Faster diagnoses;
• Fewer hospitalizations/visits;
• Less administration;
• Reduced need for rehabilitation;
• Reduced need for assistive devices;
• Fewer cases of early retirement.

Lessons learnt

Potentials of telemedicine:

• Creation of a 'joint triangle of care' by securing communication between the patient, the medical experts and the providers of care;
• Patient empowerment: Patients and relatives are more actively involved in the course of treatment and are even able to undertake simple care tasks themselves;
• Nurses see telemedicine as a helpful tool which boosts their competences, which again results in a more efficient use of expert resources: Due to the improved communication prompted by telemedicine, the medical experts do not have to be involved in the daily actions of patient care, but can instead focus on key decisions in the course of treatment.