Veterans and Providers Highlight Benefits and Challenges of TeleWound Practice Program

Key Takeaways:

• The TeleWound Practice Program (TWP) improves visit conveniency and access: Veterans and providers discussed how remote visits through the TWP made it easier to schedule and attend clinical visits, although in-person visits may still be preferred by some veterans.
• TWP technology has room for improvement: Veterans experienced technical difficulties during remote visits, and providers mentioned challenges during the initial set-up of TWP equipment, highlighting the need for technical support and training.
• Collaboration with leadership could improve TWP expansion: Providers suggested that a buy-in from leadership or partnerships with other care services could promote broader implementation of the TWP.

The Veterans Health Administration’s (VHA’s) TWP is designed to deliver technology-based care to veterans with chronic wounds. The services provided by the TWP include virtual visits with a VHA wound care specialist and asynchronous care in which patients can submit photos of their wounds for clinician review.

Since its implementation in 2019, the TWP has been associated with decreased travel burden and increased patient satisfaction among US veterans. Furthermore, the program could improve patient outcomes by reducing amputations, hospitalizations, and travel costs.

Study Methods and Outcomes

Looking to expand the TWP, researchers conducted interviews with veterans and providers to assess views on the program and its impact on patient outcomes. The interviews were informed by Practical, Robust Implementation and Sustainability Model (PRISM) guidelines.

Fifteen veterans and 7 TWP providers participated in the interviews. Investigators grouped answers into 3 categories: insights from both veterans and providers, insights from veterans, and insights from physicians.

Veteran and Provider Insights

Both veterans and providers engaging with the TWP found that the program improved patient access and engagement, increased efficiency, and reduced travel-related costs.

The TWP made attending clinical visits easier, especially among veterans with limited mobility or who had greater distances to travel. Participants saw no difference between virtual and in-person visits, instead noting how scheduling follow-ups and coordinating care had been simplified.

Participants described TWP technology as user-friendly, making it easy for veterans to upload photographs of their wounds, track its healing progress, and routinely interact with their physicians.

Although veterans and providers named multiple advantages of the TWP, they also identified a gap that should be addressed in the program’s expansion. Most veterans were not educated on the TWP or how to use its technology before encountering the program, and participants suggest providing patients with educational materials to improve their experience.

Veteran-Only Insights

In addition to streamlining remote care appointments, veterans found that the TWP improved the management of other wound care needs. Specifically, participants discussed how the program allowed providers to assist in the ordering of wound care supplies, simplifying the process.

While virtual visits may be more convenient, many veterans expressed preference for in-person visits as providers would be better able to monitor wound features such as size, color, tenderness, and drainage. This finding illustrates the importance of considering individual needs and preferences before deciding whether to utilize the TWP.

Veterans also discussed technical issues with TWP software. Some had challenges with audio or visual clarity, and others experienced connectivity issues such as delays. To optimize the TWP, veterans suggested providing technical support to improve user experiences.

Provider-Only Insights

According to providers, the TWP improved care continuity, which is significant in the realm of chronic wound care. The program allowed for more consistent monitoring of wounds as well as simplified documentation.

On the other hand, the TWP increased provider workload and administrative burden. Participants reported spending more time on documentation and struggling to keep up with administrative tasks. In addition, initial adoption and set-up of TWP technology was burdensome, creating another barrier to implementation. This finding highlights the need to improve equipment access and training for providers.

Providers also suggested the TWP secure a buy-in from local leadership or partner with other VHA services to support implementation. This could increase interest in the program and improve provider education and training.

Implications for Veteran Care

These interviews provide qualitative data on veteran and provider experiences which can help enhance the TWP and prepare it for broader implementation within the VHA health system.

Future research should build upon the positive aspects of the TWP and address the challenges and concerns identified by both veterans and providers.

According to the authors, “Acknowledging Veteran and health care providers’ positive experiences and areas of alignment while addressing these Veteran- and health-care-provider-level needs will be critical to inform the broader rollout of the TWP in a way that brings together patients, providers, and system leaders in a partnered effort to optimize access to high-quality wound care.”

Reference

Balbale SN, Wirth M, Patrianakos J, et al. Patient and health care provider perspectives of virtually delivered wound care: early lessons learned to optimize implementation. Telemed Rep. 2026;7. doi:10.1177/26924366261431988