As a second-grade teacher, Mary Higgins has a busy schedule.

As a home health nurse with Community Health and Counseling Services, Debbie Kranich has a busy schedule.

Thanks to the introduction of digital photography to CHCS’ wound care program, both women have just a little more time to devote to their professions.

Higgins has been a wound care client of CHCS since mid-November, the result of complications from open heart surgery a few months ago.

Before the introduction of digital photography, wound care would have resulted in considerably more of her time spent traveling to medical offices for consultations and treatment.

With digital photography, nearly all of the follow-up care can be done in the comfortable confines of a client’s own home, whether in Greater Bangor or other parts of Penobscot, Piscataquis, Hancock and Washington counties.

“It’s painless, and it saves time and some long trips,” said Higgins. “Living in Millinocket, having to go back and forth to Bangor for wound care can be an extreme hardship.”

With digital photography, the visiting nurse takes photos of the wound and sends them by e-mail to the CHCS wound consultant based in Bangor.

That consultant, Debbie Diehl, reviews the photographs in conjunction with other information provided by the nurse, and recommends a course of action.

The recommendation typically is done the day the photo is taken. Before digital photography, that process could have taken a week or longer due to logistical issues such as travel and scheduling.

“Digital photography allows me to help clients over a wide geographical area encompassing four counties, without leaving my office in Bangor,” said Diehl. “Because I can get clinical information and pictures within 24 hours of the client’s admission to home care, it allows me to make treatment recommendations immediately.”

Diehl, CHCS clinical nursing consultant since 1995, is certified in wound management by the Wound, Ostomy and Continence Nursing Certification Board. She completed a six-month educational program that included long-distance self-study.

In addition, she undertook a clinical practicum at MaineGeneral Hospital in Waterville that dealt with all areas of wound management, from surgical wounds to leg ulcers, and completed a national certification exam.

Diehl’s recommendations – and a copy of the digital photo – are sent along to the client’s primary care physician, who makes the final determination.

“Now, the wound consultant and the doctor can look at the pictures and make recommendations without the client having to leave the home and go to the office, which can make a big difference because of the winter weather and long trips that are sometimes involved,” said Kranich, a registered nurse with CHCS Health Services.

Digital photo updates are done as needed on a case-by-case basis, and the parties involved in the client’s wound care – including the client – can compare photos to see firsthand the healing process.

“Since instituting digital photography, we are finding that clients have become more interested and involved in their care – and that wounds are healing faster,” Diehl said.

“With the photos, we are able to provide better explanations to clients and caregivers,” added Kranich. “This improves our teaching the client and others who are helping with their care so they can have more control of their wound care. Digital photography has really enhanced our ability to deliver these services.”

Higgins agrees that being able to follow the progress of healing is aided by using digital photographs, but she appreciates the role of the photos in the treatment itself.

“You can see the pictures right through the camera right after they’re taken, but what’s comforting is knowing that the people who are looking at the photos know what they are looking at,” said Higgins. And from a clinical perspective, the accuracy of diagnosis is paramount.

“First of all, what comes to mind is the accuracy of being able to take a picture and send it by e-mail that very day to our wound consultant – to let her visualize what we are seeing in the home so she can make recommendations not just based on our measurements, our descriptions, but with a great, accurate photo to look at,” said Kranich.

“Debbie Diehl can give us accurate recommendations very quickly based on all the information we provide her,” Kranich said. “These photos are given to the physician to see the client’s progress, and the physicians have been prompt in helping us get the wound orders we need. Having that picture for them to see helps a lot.”

The digital photography and more traditional elements of wound care have been supplemented by educational materials developed by Diehl for the CHCS home health nurses.

“Having a chronic wound can be a very painful and depressing experience,” Diehl said. “My goal is for each person to get the most up-to-date and effective wound treatment, and for healing times to be reduced.

“Digital photography does not eliminate the need for doing direct client consultations. That will always be a part of my practice,” she said. “It simply allows me to provide faster assistance to a larger group of clients.”

Nancy Theriault is an area manager for Health Services at Community Health and Counseling Services. For more information on CHCS Health Services in Greater Bangor, call (800) 024-0366. For information about CHCS Health Services in northern Penobscot County, call (800) 734-7132.