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High-tech healing

October 9, 2017
by Pamela Tabar, Editor-in-Chief
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Feeling the pressure of the federal mandates to reduce pressure injuries? You’re not alone—many nursing homes still struggle with inconsistent measuring, incomplete documentation and inadequate wound management strategies across all nursing shifts, notes a 2016 study in Nursing Open journal.

The big problem with wound documentation is the subjective interpretation of its characteristics, especially when trying to capture the organic shapes of wounds using a traditional nurse’s wound ruler. How has the shape of the wound’s perimeter changed since yesterday? What exact color is the tissue in each part of the wound? How has the wound bed changed over time? How can debridement actions be captured?

While some wound-documenting applications have been around for a few years, 2017 ushered in a massive surge of mature applications for wound care assessment that are designed for use outside of the hospital environment. The pervasiveness of “smart” hand-held devices and the evolution of cloud-based computing have brought imaging technology and complex measurement algorithms down to the point of care, eliminating many of the inconsistencies linked to hand-measuring with a traditional wound care ruler.

The main selling point is better wound-measurement accuracy—some products estimate up to 45 percent better accuracy compared to ruler hand-measuring. But equally key market drivers are streamlined data documentation and standardized reporting—all important for quality and compliance.

Yet, the best blossoming benefit of the technological revolution in wound documentation may be in being able to track at-risk patients before a wound infection takes hold. By moving wound documentation to a digital platform, wound information is easily available to all nurses regardless of shift and trends algorithms can alert caregivers to emerging problems if a wound begins to go south.

Most commercially available apps provide the ability to photograph a wound and run the image through a set of algorithms that will measure the perimeter and depth of the wound bed and assess the tissue colors. Many also have integrated electronic versions of traditional wound tools such as the Braden Scale and the PUSH tool.

Here are some of the wound assessment tools that are tackling the market’s challenges:

PointClickCare, a long-term care electronic health care record (EHR) developer with U.S. headquarters in Bloomington, Minnesota, launched its Skin and Wound app in late 2016. The solution aims to solve the problems of subjective measurements, using technology to standardize how wound areas are calculated and to track healing on a consistent basis using Braden and PUSH scores.

Using a smartphone device, the software can record photos and generate reports that can be integrated with its cloud-based EHR. Data analysis software provides wound trend charts at a glance, allowing caregivers to spot subtle shifts in wound healing before they become an infectious problem.

The system’s goal is to drive outcomes, says Genice Hornberger, senior product manager at PointClickCare. “We’ve started to do some analytics around things like, how long does it take for a wound to heal? What treatment is most effective or has the fastest closure rates for each specific type of wound?” she says. “We’re looking at the data and plan to release some new analytics later this year.”

The smartphone application and its metrics, developed through a partnership with Swift Medical, are currently available for Apple devices.

Baltimore startup Tissue Analytics is working with Intermountain Healthcare, Salt Lake City, to provide a simpler, more portable alternative to laser Doppler technology to measure a wound’s rate of healing. Caregivers capture wound images and tissue perfusion using a smartphone and upload the images to the cloud.

The solution, created by two Johns Hopkins bioengineering grad students, can send data directly to certain EHRs, based on partnerships. The solution piloted at several Intermountain sites in 2016, including its home care division, resulting in marked improvements in accuracy. After several months of testing, Intermountain is now rolling out Tissue Analytics’ application across its entire health system.

“Regardless of whether you’re in the clinic or home care, you’re using the same solution to measure, document, and size the wound,” says Todd Dunn, director of innovation at the Intermountain Healthcare Transformation Lab. “There’s now consistency in documentation between multiple different settings.”

Tissue Analytics also offers its app directly to patients, who can take images and track their own wounds—an interesting and home health-friendly twist to the wound care documentation market.

The Tissue Analytics application runs on Apple iOS and Android platforms.

New players

Plenty of interesting companies are jumping into the hot market of wound care.

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