Telehealth and Wound Care: Where It Falls Short

Telehealth has reshaped many areas of healthcare in recent years. In primary care, psychiatry, and chronic disease management, virtual visits have expanded access and added convenience. During the COVID‑19 pandemic, telemedicine use in the United States surged from under 16 percent of physicians using video telehealth before 2020 to more than 86 percent by 2021 according to national survey data from the Centers for Disease Control and Prevention.

This rapid growth showed telehealth could help maintain care when in‑person visits were difficult. Yet wounds are physical, evolving conditions that often require direct examination and hands‑on treatment. When wound care relies too much on virtual tools it often falls short of what patients truly need. Why Wound Care Is Different Wound care is inherently tactile. A provider needs to see the wound in detail and feel the tissue to accurately judge its condition. Visual changes can be subtle and depth difficult to assess over a camera. Even when high‑quality photos or video are shared, they may fail to capture critical details like tissue texture, firmness, or drainage. Poor lighting, camera angle, and image compression make accurate remote assessment challenging.

Telehealth also cannot replace real‑time decisions that occur at the bedside, such as debridement or dressing selection based on texture and appearance. These hands‑on interventions are at the core of effective wound management and require clinical skill that patients and caregivers may not possess. Mixed Evidence on Telehealth in Wound Care Early research has evaluated telemedicine for chronic wound management with mixed results. Some studies show that telehealth can achieve similar outcomes in healing time and safety compared to standard care. Other research suggests telewound care may improve certain outcomes such as healing scores and quality of life when it is paired with in‑person visits.

However, evidence is inconsistent about telehealth’s effectiveness as a stand‑alone solution for wound care. A scoping review of telewound care studies concluded that existing research is weak and inconsistent, and that more rigorous studies are needed to understand its value. This reflects important challenges in applying telemedicine to a specialty that depends on repeated and accurate physical evaluation. The Limitations of Virtual Assessment Telehealth can help in certain aspects of wound care. It can support remote education, help with scheduling and triage, and enable preliminary discussions with patients and caregivers. But there are limitations that make virtual care insufficient on its own for many wound patients.

Poor image quality can distort the appearance of a wound and lead to incorrect assessments. Caregivers may not know how to hold a camera steady or may focus on the wrong area of the skin. Lighting can hide important signs of infection or tissue damage. Even advanced apps that use machine learning to assess wound photos face challenges in ensuring consistency and accuracy across diverse home environments.

Telehealth also depends on reliable technology. Not every patient has access to broadband internet or devices capable of high‑quality video. Facilities may not have staff available to assist with virtual visits. For older adults with cognitive or sensory impairments, virtual communication can be confusing and less effective than in‑person support. When Telehealth Works Best Telehealth can play a supporting role in wound care when used alongside in‑person care. Suitable uses include:

• Initial triage of new concerns so a provider can determine if a visit is urgent

• Follow‑up discussions about symptoms or changes that don’t require a physical exam

• Education for patients and caregivers on wound care best practices

• Coordination with other providers to adjust medications or care plans
  

In other words, telehealth can enhance communication and convenience, but it does not replace the need for direct clinical examination and intervention. Why Bedside Care Still Matters Patients with wounds, especially chronic or complex wounds, benefit from regular physical evaluation by trained clinicians. Physicians who practice wound care in person can see subtle changes in tissue color, smell, temperature, and depth. They can perform procedures and make informed decisions in real time.

Physical presence also builds trust. Patients who struggle with mobility, diabetes, vascular disease, or other comorbidities feel more confident when a clinician examines their condition directly. This confidence can improve adherence to care plans and promote better outcomes. The Skilled Wound Care Approach At Skilled Wound Care, we value the role of telehealth for specific purposes but we emphasize in‑person wound management as the core of high quality care. Our physicians visit patients on site, build relationships with care teams, and provide comprehensive assessments that integrate clinical insight with practical intervention strategies.

In post‑acute and long‑term care facilities, that kind of presence can improve outcomes, reduce hospital readmissions, and support teams in learning best practices for prevention and early intervention.

Telehealth has a place in modern healthcare, and it has improved access to many services. Large increases in telemedicine use during the pandemic demonstrated that clinicians and patients could adopt new modes of care delivery when needed.

In wound care, however, telehealth should be regarded as supplemental. It can help with initial screening, communication, and follow‑up. It cannot replace the value of direct clinical examination and skilled intervention that most wound patients require.

Patients deserve a comprehensive approach that includes both technology where appropriate and consistent bedside care when it matters most. Clinicians who understand these limitations and adapt accordingly are best positioned to deliver optimal wound care in today’s healthcare environment. Learn how Skilled Wound Care supports physicians in delivering hands-on care where it’s needed most.