Barriers to the implementation of virtual care programmes for patients with chronic wounds: Qualitative empirical research.
Nasib Babaei, Vahid Zamanzadeh, Leila Valizadeh and 4 others
PMID 37612895WHAT IT FOUND
Wound therapists in Iran identified five major barriers to virtual care: lack of legal frameworks and funding, privacy risks, patient digital illiteracy, and the inability to physically examine wounds.
They noted that remote assessment misses critical signs like smell and drainage consistency, making it unsafe for complex cases.
Key findings
01Participants identified lack of policymaking, ethical challenges, social/economic issues, insufficient user knowledge, and scope limitations as the five main barriers to virtual wound care.
02Therapists reported that virtual care prevents essential physical examinations, such as palpation and assessing wound odor or drainage, which are critical for clinical decision-making.
03Elderly patients and those with lower digital literacy were described as facing significant hurdles in using technology, potentially leading to unequal access to care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not include the perspectives of patients with chronic wounds, so the barriers identified are solely from the provider's viewpoint. The sample was small (12 participants) and limited to Iran, which may affect the transferability of findings to other healthcare systems with different legal and technological infrastructures. Some wound therapists were unwilling to participate due to time constraints, which may have introduced selection bias.
Declared interests
The work was supported by the Research Deputy of Tabriz University of Medical Sciences. The authors declared no potential conflicts of interest.
The easy way to misread this
Do not interpret these findings as evidence that virtual care is ineffective or should not be used. This study reports the barriers to implementation from the perspective of providers in a specific context (Iran), not the clinical outcomes of using virtual care. It does not prove that virtual care leads to worse patient outcomes, but rather that specific logistical, legal, and physical assessment challenges exist.