November 20, 1998

Jonathan Gertler, MD, views Nunes' images with Evelyn Ho, RN

Ho takes a digital photo of Helen Nunes' leg wounds.

As sunlight pours through her living room window, Helen Nunes sits in her favorite chair and waits patiently for Evelyn Ho, RN, to take pictures of her right leg. To Nunes, the digital camera Ho is using is just one of those "new-fangled" gadgets. But for Ho, this gadget is an immediate connection to MGH expertise.

As part of the MGH Vascular Home Care Program, Ho makes home visits to patients after they have been discharged from the MGH. During each visit, Ho takes a digital photograph of her patients' vascular wounds – wounds from surgical incisions, graft failures or nonhealing ulcers. Instead of using film, Ho's camera stores images in digital memory to be downloaded directly into a computer for instant viewing.

Using a laptop computer, Ho is able to transfer the digital images to computer terminals at the MGH. Vascular surgeons can directly view patients' wounds and recommend treatment options to the home care nurse.

With this telemedicine technology, Jonathan Gertler, MD, Nune's physician, can monitor her progress from his office without seeing her in person. Since physicians can monitor their patients closely, patients can be discharged sooner and avoid trips back to the MGH, while receiving high-quality care in their own home.

"Digital imaging has tremendous possibility for keeping patients, especially elderly patients, from making unneeded visits to the hospital as well as saving costs," says William Abbott, MD, chief of the MGH Vascular Surgery Unit, who spearheaded the project.

According to Syam Buradagunta of MGH Telemedicine, who has been instrumental in the project, high-quality images have been produced for 60 patients in the pilot stage so far.

"The fruits of this project are being expanded into care delivery for other specialties including dermatology, remote stroke management and home care of congestive heart failure patients," says Joseph Kvedar, MD, director of MGH Telemedicine.