Dr. John A. Phillips, MD is a cardiology and peripheral vascular interventionalist and has significant experience in wound care as it pertains to vascular causes. Dr. Phillips speaks nationally and internationally on peripheral arterial disease, and has authored numerous papers in peer-reviewed journals pertaining to his specialty.
Following is a conversation with Dr. Phillips about his ideas for improving how chronic wounds are analyzed, by implementing easy-to-use software to assist in image analysis and healing progress trending.
Interviewer: In post-acute care like skilled nursing facilities or home health or outpatient wound care centers, what do you see as the biggest opportunities for improvement?
Dr. Phillips: Patients can sometimes have a wound that despite treatment, continues to get larger and not heal. Part of our ability to judge wound healing is through regular imaging of the wound. If the wound is not getting imaged or if its dimensions are not being documented on a regular basis, we have no way of objectively tracking wound healing. This can have devastating effects on the patient, and can potentially lead to limb loss. Some nursing home facilities may not know they need to do this, or they may not feel they can access experts who can help them. Having said that, there are mobile technologies out there to help care for the patient, as well as allow for instant communication between care sites and wound care experts. There are a lot of moving parts though. It is more than just taking a picture; how do we document the true size of the wound? And who is ultimately responsible for looking at the wound? We cannot just take pictures without a treatment plan or knowing what the wound looked like last week or last month.
Let me tell you what I have seen at many wound care centers. When I want to document a wound, I take a picture and it goes into the chart in the EMR (Electronic Medical Record). The problem is, I cannot access it on my phone and cannot share it. I cannot get to the data – only the picture itself and still can’t easily see all the pictures from prior dates. The top wound analysis software products provide a secure platform for sharing information. These tools provide reproducibility, accuracy and ease of sharing – all to positively impact these patients, often the sickest of the sick. If we have access to a mobile software application that simply takes an image, calculates important characteristics, and permits a team of caregivers to share, why not utilize it?
Interviewer: What do you feel are the most important characteristics to measure in patients who are dealing with chronic wounds?
Dr. Phillips: We are looking for reduction in size. Is it getting smaller or bigger in terms of actual area? Not square area, but actual surface area – which cannot be calculated manually with a ruler. If you do not have the ability to take an image and document the reduction of area / size, you are not fulfilling the guidelines required by many insurance payers to show you are actively treating the patient to heal their wound. You need accurate data points to show these payers that you are improving the wounds and doing it in a timely manner. Many places are simply taking pictures, but are manually measuring the wound, which may not be the most accurate way to document wound healing.
Why don’t all post-acute facilities use image capturing software? One of the issues is cost and many facilities do not want to pay for something they perceive that they do not need. However, in my mind, these costs need to be looked at from both a short-term and long-term perspective. What does it cost, both in hourly wage and efficiency for the nurse or provider to measure and trend wound healing manually? There is also a cost to not document the size of the wound correctly, ultimately leading to decreased reimbursement – or worse, not healing the wound for the patient, with dire consequences. My advice to my team is simple– how can we be more efficient and in the long run save money for both the patient and health care system at the same time healing wounds faster? If we have a goal of where we want to be, and if we are not there yet we need to change what we are doing. At the same time, if we have technology that can help us get there, why not consider using it? If we never change, we would still be using rotary phones and CD’s, instead of an iPhone. How do we pivot from reactive to proactive and move things forward?
Interviewer: Can you tell us about some of the innovations you see that can help heal patients with chronic wounds?
Dr. Phillips: Patients that have chronic wounds typically have many other medical problems and require close surveillance. My opinion is that the more information you have about an ailment, the better you are equipped to treat it. I look for technologies that I can utilize that have the ability to quickly assess a wound with an image, acquire data points that are reproduceable, and allow those of us who take care of wounds to use the data to help us achieve our objective…healing the wound. When you have technology that fits into the palm of your hand, is easy to use, and has high-quality and is FDA registered, you are checking the all the boxes as to what you need for imaging technology in the medical world. I have experience with WoundWiseIQ, which is one excellent example of an outpatient device that analyzes wound characteristics and trends them. WoundWiseIQ helps us keep a close, accurate watch on patient wounds.
Dr. John A. Phillips, MD is a cardiology and peripheral vascular interventionalist in Columbus, Ohio. Dr. Phillips speaks nationally and internationally on peripheral arterial disease, and has authored numerous papers in peer-reviewed journals pertaining to his specialty. Dr. Phillips has developed significant experience in wound care and has developed his own application that allows a patient to communicate – via the app – directly with a physician to share wound images and secure wound healing advice. Dr. Phillips is on the Advisory Board for wound care technology leader Med-Compliance IQ (www.medcomplianceiq.com), and functions as the company’s Chief Innovation Officer.
To learn more about the latest developments in wound imaging, or to view a demonstration of a powerful tool to improve wound healing analysis, visit www.WoundWiseIQ.com.