At the 2025 Diabetic Foot Wound Congress in Montpellier, Tatiana Bénard — specialist wound care coordinator nurse at the Diabetic Foot Unit of Sud Francilien General Hospital (CHSF), presented a detailed account of how her team uses Pixacare to structure remote wound monitoring for patients with diabetic foot wounds.
The presentation, now available as a video recording, illustrates how a hospital unit can build an effective, secure and collaborative remote monitoring pathway between the hospital and community care teams.
A specialist unit facing growing demand
The Diabetic Foot Unit at Sud Francilien General Hospital brings together a multidisciplinary team: diabetologists, specialist and coordinator nurses, podiatrists, orthotists, prosthetists, advanced practice nurses and a ward manager.
The unit's activity spans:
- Specialist outpatient consultations
- Close coordination with community care providers
- Emergency and inpatient advisory support
- Training and clinical research
As specialist centres become increasingly scarce across the country, patient numbers are rising while consultation capacity remains fixed. A structured system for continuous monitoring between appointments had become necessary. Photographs sent via SMS or WhatsApp were too inconsistent, insufficiently secure and difficult to compare over time.
A 2022 cyberattack that paralysed the hospital's IT systems and caused a data breach further underlined the need for a secure, structured solution.
From the TÉLÉPIED study to Pixacare
Before adopting Pixacare, the team had conducted the TÉLÉPIED clinical study — a manually operated remote monitoring programme run by an expert nurse, based on photographs sent by email or SMS and supplemented by home visits.
The study demonstrated:
- A 50% reduction in care costs
- Fewer hospitalisation days and readmissions
- Equivalent healing and amputation rates across both groups
It validated the potential of remote follow-up in diabetic foot wound management — but the model was difficult to scale. In 2023, at the Wounds and Healing Congress, the team discovered Pixacare, which offered a way to automate and secure everything that had previously been done manually.
A fully structured remote monitoring pathway since June 2024
Since June 2024, all patients seen at the unit — whether in outpatient consultations, day hospital or inpatient settings, including emergency presentations — are enrolled in remote monitoring via Pixacare, with their consent.
Two pathways run in parallel.
Patient-led monitoring
- Automatic weekly SMS prompt
- One-click photograph upload, no app download required
- Early complication detection questionnaire
Community nurse monitoring (district nurses, home hospitalisation, nursing services)
- Unique QR code issued by the hospital physician or coordinator nurse
- Free application for community nurses
- Photograph capture and clinical questionnaire
- Secure messaging with the hospital team
Key features used at Sud Francilien General Hospital
Tatiana Bénard highlighted the functionalities most relevant to a specialist unit.
Structured medical image library
All photographs are linked to the patient record and accessible to every authorised clinician — diabetologists, nurses, vascular surgeons, infectious disease specialists and emergency physicians.
Secure collaborative messaging
This has significantly improved hospital-community coordination. Teams use it to exchange on offloading protocols, request rapid opinions and discuss care adjustments. It effectively replaces SMS, WhatsApp and standard email exchanges, none of which meet the required standards for clinical data confidentiality.
Wound documentation
A key asset for the unit: rapid wound annotation, intuitive manual planimetry, healing curve tracking, clinical data entry and automatic PDF report generation integrated directly into the patient record.
Early detection of complications
Through mandatory infection questionnaires, automated alerts and visual comparison of photographs over time. Several patients were readmitted earlier as a result — often directly to the diabetology ward, bypassing the emergency department entirely, with a measurable improvement in outcomes.
Clinical benefits observed
The team reports the following benefits, both expected and already confirmed in practice:
- Reduced healing time through closer follow-up
- Fewer hospitalisations and readmissions
- Earlier identification of clinical deterioration
- Secure, high-quality clinical exchanges
- High adoption rates among community nurses and patients
- Lower overall care costs
Pixacare has become a structural coordination tool between hospital and community — essential in the management of complex wounds.
Clinical cases presented
Tatiana illustrated the real-world impact of remote monitoring through three cases.
A straightforward healing trajectory
Regular photograph monitoring, combined with timely advice and adjustments, enabled a rapid and positive outcome.
A stagnating wound
A patient submitted daily photographs for a month with no visible improvement — a non-healing wound despite multiple local treatment adjustments. Early readmission for larval therapy led to rapid healing shortly after.
A silent deterioration
Visual comparison of photographs over time revealed signs of skin and soft tissue infection. Urgent blood tests were requested and the patient was readmitted immediately, without going through the emergency department.
The limits of photographic monitoring
Tatiana was clear on this point: a photograph remains a photograph. Certain clinical information cannot be captured through images alone — wound depth, temperature, bone contact, and the quality or quantity of exudate. Image quality also depends on angle and lighting conditions.
The clinical questionnaire and direct communication with community nurses therefore remain essential to complete the assessment.
Next steps
The unit has identified several areas for development:
- Wider promotion of Pixacare among community nurses through primary care networks and health insurance bodies
- Use of the platform for initial clinical opinions
- Expanded use of video to assess the foot as a whole and the wound from multiple angles
- Continuation of the expert coordinator home visit model developed during TÉLÉPIED
- Ongoing research: results of the PIXAPROM study forthcoming
Conclusion
For Tatiana Bénard, Pixacare is an essential remote monitoring tool : one that improves wound follow-up, strengthens hospital-community coordination, secures clinical data and optimises team organisation.
She is equally clear, however, that the model depends on people as much as technology. Nursing time, community carer engagement and the formal recognition of this work — currently unremunerated — will be critical to sustaining this approach over the long term.
