The Leg Ulcer Telemedicine (LUTM) Service was programmed and developed by consultant vascular surgeon Simon Dodds at the Good Hope Hospital, Sutton Coldfield, in his spare time. It consists of a secure electronic clinical record system that allows the storage and processing of colour images.
The software, which is operated by the community nurse, takes measurements of colour and size from the image of the wound. These measurements can then be plotted over time in a graph that allows clinicians to check whether, or how fast medication is working, and to project future courses of treatment. The nurse can electronically refer the patient at any stage to a specialist or for an outpatient assessment, transferring the record and the image.
Simon Dodds stated that the new system has had a great impact on patient care: "When I started at Good Hope Hospital in 1999, I found a group of over-worked, stressed and demoralised clinic nurses. We now have an enthusiastic team of specialist nurses who are delivering high quality care, who are motivated because they can see the results of their work and who are highly valued for their opinion." Analysis of the pilot data revealed that the healing rate among patients had risen sharply to 64 percent from 22 percent before the scheme began.
The system is not only being operated in North Birmingham PCT, but also in North Hampshire, and a pilot is underway in Liverpool, and can be used in a whole variety of similar situations in dermatology, for instance pressure sores or diabetic foot ulcers. Simon Dodds explained that the service has been designed to be scalable: "In principle, the clinical process and LUTM software could be applied immediately across the NHS, and, with appropriate support, could almost immediately start to deliver similar improvements to a much wider population."
"It would be perfectly feasible to use the existing software to create a National Leg Ulcer Electronic Care Record Service, and to evolve this to integrate seamlessly with the National Programme for IT", added Simon Dodds. The development team had first looked at live transmission of images, but decided that the system was not cost-effective or user-friendly enough. The GBP15.000 prize will be spent on further development and implementation of the service.