This document summarizes literature on the use of telehealth in Australia to manage chronic leg ulcers, particularly in remote populations. It discusses how telehealth can help assess ulcers, provide nurse interventions, and improve healing rates. Several Australian examples are described where telehealth was used by podiatrists, in remote indigenous communities, and integrated into a health information system. The conclusion emphasizes identifying target group needs, evaluating improved health outcomes, and balancing direct patient contact with telehealth benefits.

1. Australian utilisation of TeleHealth to assist in
the management of chronic leg ulceration.
IMPORTANCE and SCOPE
Outlier populations.
Disadvantaged Populations.
Common problem,aged and diabetic population
Important health consequences(amputation)
Colin STYLES 2012

2. Proof of Concept.(Literature Review)
1.Ulcer Assessment.(Bowling 2011)
2. Clinical outcome, telehealth assisted nurse intervention.(Wilbright 2004)
Utilisation.(Literature Review)
78 citations “ehealth skin ulcer” ,steady flux over last 5-10 years.

3. Relevant eHealth Questions
For Whom?
For what Clinical Problem(s)?
Is it reliable(safe)?
Which program?
How to implement the program?
Is it Economically justified?

4. Australian Examples.
1.Bega N.S.W. Podiatrist initiated study,patient acceptance and preference.
Access to expert consultation in Sydney.(Devine 2007)
2.Kimberley.W.A. Randomised control Study in remote indigenous communities,
better ulcer healing rates and fewer amputations.
(Santamaria 2004)
3.Queensland. Example of Telehealth integrated to a Health Information
System,”Auscare”. Six target groups,3 metropoloitan
Brisbane and others distance sites.(Lazzarini 2010)

5. Example of W.A. Telehealth

6. Overview of eHealth and the Electronic Deloitte
Health Record Strategy. 2006
Beware that telehealth does not fragment patient records and
create
a profusion of special interest groups.
Opportunities with the National Broad
Band.
Monash Uni. Pub.2011

7. Conclusion—A Process.
1.Identify the needs of a Target Group
2.Is the Telehealth solution an(possible)improvement on what exists?
3.What is the Telehealth solution? Technical,Staff and training,acceptance,
capital outlay and operating costs.
4.Integration into Health informatics profile.Common standard.
5.Are there improved Health Outcomes?
6.Program evaluation.Modification.Abandonment.
7.Economic Evaluation.
8.Tolerance for Evolution.
9.Risk Analysis. Loss of direct patient contact,skilled hands on care ,
loss of personalisation,legal,remunerative,Overview.

8. References.
1. Remote assessment of diabetic foot ulcers using a novel wound imaging system.
Bowling F, King L, Paterson J. et al.
Wound Rep. Reg 2011; 19:25–30
2. The Use of Telemedicine in the management of Diabetes-Related Foot Ulceration: A Pilot Study
Wilbright W, Birke J, Patout . et al.
Adv skin wound care 2004; 17:232-38.
3. User satisfaction and experience with atelemedicine service for diabetic foot disease
in an Australian rural community.
Devine J.
Greater Southern Area Health Service (GSAHS).NSW Health.
4. The effectiveness of digital imaging and remote expert wound consultation on healing rates in
chronic lower leg ulcers in the Kimberley region of Western Australia
Santamaria N, Carville K, Ellis I et al.
Primary Intention 2004; 12(2): 62-70.
5. Does the use of store-and-forward telehealth systems improve outcomes for clinicians
managing diabetic foot ulcers? A pilot study
Lazzarini A, Clark D, Mann D, et al.
Wound Practice and Research 2010;18(4):164-172.