Navigating the Shifting Model of Wound Care and Podiatry During the COVID-19 Pandemic

  • Through the contribution of podiatry during the COVID-19 crisis, diabetic foot wound hospitalizations, emergency room visits, and lower-limb amputations have been reduced.
  • By providing the expertise in care for diabetic foot patients that are experiencing complications and lower extremity wounds, podiatry is helping to keep patients out of the hospital and reducing their risk of contracting the novel coronavirus.
  • Wound care clinics around the nation began closing their doors or limiting their hours at the onset of the pandemic.

The New Normal

Even though many states are opening up in phases, the pandemic medicine protocol from the COVID-19 pandemic is predicted to last at least 18 months. Until a vaccine for the novel coronavirus is developed and fully distributed all healthcare services will continue to operate under the pandemic care model. This is going to last for the foreseeable future. Foreseeable. There is an end in sight, but that end will not likely be in the year 2020.

Providers should follow modified triage and escalation schematics for wound care during the pandemic.

Podiatrist’s Role in Diabetic Foot Care Heightens During COVID-19 Pandemic

Podiatry has made significant contributions during this pandemic and will continue to do so. Through the contribution of podiatry during the COVID-19 crisis, diabetic foot wound hospitalizations, emergency room visits, and lower-limb amputations have been reduced. Additionally, if a patient is hospitalized podiatrists have worked to reduce the average length of stay for the patient.

Despite the focus straying away from the statistics in the media, hospitals are still experiencing an influx of new COVID-19 patients and a dramatic resurgence is expected by many in the medical field. Podiatrists are in a position to greatly ease the buron on hospitals and emergency rooms during this time of medical crisis. By providing the expertise in care for diabetic foot patients that are experiencing complications and lower extremity wounds, podiatry is helping to keep patients out of the hospital and reducing their risk of contracting the novel coronavirus.

Before the pandemic, the complete focus of wound care was to heal the wounds of patients at any cost. As we are “in the thick of it”, the goal has transitioned to avoiding the hospitalization of diabetic wound care patients at all costs. Waivers for podiatry and wound care providers to perform telemedicine and in-home care from CMS has enforced the push for more services to be performed on a remote basis as a priority as well as in the home if tissue or cellular-based dressing, debridement, or contact casts become a necessity. Wound care goals have to be modified for the safety of both the patient and the provider. Providers should follow modified triage and escalation schematics for wound care during the pandemic.

The Alliance of Wound Care Stakeholders Submits Request for Emergency Relief to CMS

The Alliance of Wound Care Stakeholders submitted a letter of request for emergency relief to CMS that asked for provisions to help wound care providers take care of wounds through the usage of telemedicine and/or in the home care setting. The Alliance represents a group of parties that are interested in the provision of wound care with the lawmaker and policymakers in Washington, DC. As advocates on behalf of wound care providers, allied health, management companies, manufacturers, and distributors the focal point for the letter was to address the need for expanded telemedicine regulations past the point of pandemic care.

Wound care clinics around the nation began closing their doors or limiting their hours at the onset of the pandemic in response to the directions from government bodies and the United States Surgeon General to either cancel or postpone any current appointments. Some states are now performing elective procedures and appointments, but most are still restricting what providers can do and advising clinic operations under pandemic medical protocol.

Wound care clinics are quite often found within the physical space of local hospitals. Because hospitals are still limiting visitors until phase three of the reopening state of their practice, their operations are hindered because of the pandemic. Even though wound care has been declared non-essential by some states, the Alliance of Wound Care Stakeholders has declared the service to not only be preventative but essential for sustaining healthy limbs and life for those who are battling diabetic foot wounds and more.

The wave of telemedicine usage has surged dramatically with the COVID-19 pandemic.

The Provision of Podiatry and Wound Care through Telemedicine

First and foremost, is it of utmost urgency for the provider to stay current. The rules and regulations for telehealth are evolving at a rapid pace. Keeping a well-updated understanding of how telemedicine is being governed in your state both on the licensure side and the billing side is of extreme importance.

There are state-to-state variations on what is authorized in treatment provision. Check with not only the state the clinic is in but the state where all patients reside that will be treated through the use of telemedicine. The Federation of State Medical Boards offers a document online that can be used to see which states are offering waivers on licensure requirements and what existing circumstances are involved in the waiver. Providers are regulated by their scope of practice in the state that the patient resides in, this is the state that will waive the license. If the provider practices in Kansas City, Missouri, and the patient resides in Kansas City, Kansas then Kansas will be the state that licensure waiver must be gained.

Be sure there is a firm understanding of what your malpractice policy will cover as far as telemedicine health care delivery. All telemedicine activities should be reported to your carrier. Any liability potential will be under the jurisdiction of the state that the patient resides in and any lawsuits that are filed will be filed in that state. This makes a consultation with the provider’s malpractice company to discuss coverage for telemedicine visits ultra urgent.

The New Normal Recapped

The wave of telemedicine usage has surged dramatically with the COVID-19 pandemic. After this crisis is over, telehealth is expected to be a normal option for the delivery of health care to patients nationally. Supplying patients who are candidates for telemedicine with the knowledge of how their care will be administered is going to be key to their comfort with utilizing this option. The patient’s comfort is important, therefore appointing at least one staff member to be responsible for this sole goal would be beneficial.

This is a prime opportunity for podiatrists across the United State to cement their place in health care delivery during this pandemic. Podiatry is playing a vital role in protecting the vulnerable population of diabetics and other patients with wounds.

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hwest

Heidi West is a medical writer that writes about healthcare and technology.

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