What telehealth wound follow-up is
Telehealth wound care follow-up is a check-in with the treating clinician by video, or a review of wound photos, between hands-on visits. It adds to in-person care and does not replace it. A wound still needs to be examined and measured in person on the schedule the clinician sets.
Gateway arranges these check-ins in Greater St. Louis and the Metro East when the treating clinician decides one is appropriate, based on the wound and on what can be judged safely from a screen.
When a video or photo check-in may fit
The treating clinician may suggest a remote check-in for:
- A look at the skin a few days after a change in dressing or treatment
- A question from a caregiver or home health nurse during a dressing change
- A stable wound being watched between scheduled visits
- A week when weather, illness or a ride that fell through would otherwise delay a check-in
What a screen cannot do
A camera shows the surface. It cannot show how deep a wound is, whether there is a pocket under the skin edge, or how the tissue feels. The clinician cannot check warmth, pulses or sensation, and cannot smell the wound. Color shifts with lighting and with the phone, which makes redness harder to judge, especially on darker skin.
Anything that takes hands still takes a visit, including measuring depth, removing unhealthy tissue and applying compression. A new wound usually calls for an in-person assessment. If a video check-in leaves a question open, the clinician may ask to see the wound in person.
How Gateway arranges a remote check-in
We first confirm with the treating practice that telehealth can be offered for your situation. That depends on the practice, your health plan and where you are at the time of the visit, since rules differ between Missouri and Illinois.
Then we set the time, explain which video or photo tool the practice uses, confirm who will be with you, and make sure the clinician has the latest notes and measurements. Please do not send wound photos through our website form or by ordinary email. The practice will tell you how to share them.
Getting ready for a video or photo check-in
- Pick a spot with good light. Daylight from a window usually works better than a flash.
- Ask someone to hold the phone if the wound is hard to reach.
- Show one view from a step back, so the clinician can see where the wound is, then one close up.
- Ask whether to time the check-in with a planned dressing change, so the dressing is not removed more often than ordered.
- Have clean supplies ready to cover the wound again.
Our guide to telehealth and wound photos has more detail. It also helps to practice describing wound changes in plain words, because what you notice day to day fills in what the camera misses.
Telehealth in facilities and with home health
A remote check-in often works best with a nurse at the bedside. In a skilled nursing facility or assisted living community, a staff nurse can remove the dressing, hold the camera and report measurements. At home, a visiting nurse can do the same, which is one way we support wound care alongside home health.
In-person care continues too, through mobile wound care visits at home or scheduled rounds in a facility.
Connecting with the rest of your care
The treating clinician documents what was seen and any change in orders. Gateway passes updated orders to the supplier, the home health agency, the facility nurse or the family member doing dressing changes. With your permission, notes also go to your primary care clinician. Some patients use video for general medical follow-up as well, through telehealth primary care visits.
When not to wait for a screen visit
Call the treating clinician’s office promptly about spreading redness, new warmth or swelling, pus, a stronger odor, fever or chills, skin turning dark, or worsening pain. Our page on the signs of wound infection explains what to watch for.
Telehealth is not for emergencies. For bleeding that will not stop, chest pain, trouble breathing or sudden confusion, call 911.
How to start
Call Gateway at 314-325-0126 or send a request for care with just your name and phone number. When we call back, tell us whether a clinician already follows the wound and whether you want to ask about video or photo check-ins.
Common questions
Can telehealth replace my in-person wound visits?
No. A video visit or photo review is an extra check-in between hands-on visits. The treating clinician still needs to examine and measure the wound in person, and many treatments can only be done face to face. How often each kind of visit happens is the clinician’s decision.
Do I need a smartphone or special equipment?
Most video check-ins work on a smartphone or tablet with a camera and an internet or cellular connection. If you do not have one, or are not comfortable using it, tell us. A family member, a home health nurse or facility staff may be able to help, or the clinician may decide in-person visits fit better.
Does insurance pay for telehealth wound check-ins?
It depends on your plan, the treating practice and the type of check-in. Telehealth rules vary between Medicare, Medicare Advantage, Medicaid and commercial plans, and they change over time. Ask your plan and the treating practice before the visit what applies to you and what you might owe.
Can a family member join the video visit from another city?
Often, yes. Many video tools let another person join, and the treating practice can tell you how. The patient, or the person who legally makes health decisions for them, needs to agree. Tell us ahead of time who should be included.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.