Description:
TOBI: Telemedicine Optimized Burn Intervention
Technology: Through a collaboration of MUSC experts in pediatric burn care, health communication, nursing, public health, biostatistics, information technology, and clinical psychology MUSC has developed a mobile application (TOBI) that allows for tertiary clinical burn care in the home by connecting patients and families with expert burn nurses and physicians. The app enables burn physicians and nurses the ability to monitor and intervene during the injury assessment and wound care phase of the treatment of a serious burn. Based upon how the wound healing is progressing, the burn nurse will send informative and encouraging text messages concerning the healing process. The app allows for the parent to interface with the burn team through secure SMS messaging or videoconferencing. Additionally, parents can see instructional videos for dressing changes depending on the patient’s age and location of the burn, as well as find answers to frequently asked questions (FAQs).
To date, A 9-month proof of concept project was conducted with pediatric burn patients and their caregivers (patient mean age 4.9 ± 4.3 years, range: 1–17) with partial thickness burns between September 2016 and June 2017. Forty-three patients came from a total of 14 counties throughout the state of South Carolina, with 50 per cent of patients potentially traveling greater than 100 miles from home for burn care. Even with similar burn injury severity, those that utilized TOBI saw better average healing times, reduced clinical encounters and were more compliant with at home care.
Additionally, if a burn is found to be non-healing with primary therapy, a change in therapy should be instituted in a time sensitive manner. TOBI will permit the more responsive recognition of this need and thus enable a more rapid change of primary therapy, particularly for those patients that are located a significant distance from a primary burn center.
Overview: Annually in the United States approximately 486,000 patients sustain burns that required medical treatment, with approximately 40,000 hospitalizations and 3,240 deaths. 90% of burns are treated in the outpatient setting, and these injuries require repeated clinic visits over 7-21 days to assess burn evolution, healing, and complications. Specifically, pediatric burn injury remains a major public health problem, with approximately 160,000 serious pediatric burn injuries annually in the United States. Meanwhile, the number of verified burn centers has decreased by 30 per cent since the 1990s.
With only ~40 ABA-certified burn centers in the US, follow up care can be cumbersome for patients not living near a burn center. Regional access is highly variable with significant gaps in access in rural areas. Approximately 91 per cent of serious pediatric burn patients are treated on an outpatient basis with intensive wound management and dressing changes. These parents and their children often travel long distances for repeated visits to the burn center to ensure that the burn heals without complication, often requiring three or more visits over the 10 to 14 days routinely needed for a partial thickness burn to heal. Mobile health (mHealth) technology offers a promising approach to address these barriers in this patient population, particularly in the outpatient setting.
Applications: Tertiary clinical burn care in the home
Advantages: Ability to monitor and intervene at home, available from any computer or smartphone, videos tailored to patients’ age and burn location, ability to communicate with skilled burn team remotely
Key Words: Burn, mobile application, telemedicine, pediatrics, compliance, wound healing
Inventors: Aaron Lesher, Sachin Patel, Ryan Howard, Frank Treiber
IP Status: Copyright
Publications: Denise I Garcia, H Ryan Howard, Robert A Cina, Sachin Patel, Ken Ruggiero, Frank A Treiber, Aaron P Lesher; Expert Outpatient Burn Care in the Home Through Mobile Health Technology, Journal of Burn Care & Research, Volume 39, Issue 5, 17 August 2018, Pages 680–684, https://doi-org.ezproxy-v.musc.edu/10.1093/jbcr/iry013
Awards:
American Burn Association Shriners Best Pediatric Burn Paper Award, 50th Annual Meeting of the American Burn Association, April 2018, Chicago, Ill.
Innovation award at the American Pediatric Surgery Association Annual meeting, Palm Beach, California, May 2018.
MUSC-FRD Technology ID: P1788