Genesis

Jeanine Maguire

Wound management has been the black sheep specialty within the medical arena that many healthcare professionals shy away from, especially when the wound type itself is often elusive at best. In some cases, the wound type is diagnosed based solely on documentation from a clinician and their subsequent best guess of the observed wound. Sometimes conflicting wound types are diagnosed for the same wound by different clinicians or across different settings. This is similar to how individuals may describe a home on an Airbnb very differently and chances are that without a photo, these descriptions may fall short of the real deal. Wounds are one of the rare medical conditions where a quality photo can indeed result in accurate wound type diagnosis, or at least lead to the right diagnostics for differential diagnosis. Increasing the ability of healthcare providers to accurately diagnose wounds is a major step toward mainstreaming the specialty of wounds managed by giving the clinicians an objective tool and confidence in directing care options.

Wound management suffers a lack of healthcare system readiness in part due to the lack of knowledge of the wound types that may exist within each facility or system. However, wounds and participially chronic wounds are increasing in parallel with population aging. It is estimated that today there are more than 1.2 million people with pressure injuries and that at least 15 percent of the Medicare population has some type of chronic wound. Further, those more than 65 are expected to double by 2050, which will cause the current $28 billion allocated to wound care to drastically rise resulting in a significant societal burden. Despite that uptick, it is seldom that facilities or systems have clear data reporting all wound types, such as, pressure injuries, diabetic neuropathic ulcers, venous leg ulcers, arterial ulcers, or other. A new level of wound type accuracy and data are all needed to support system wide readiness to support this growing population.

"New wound app technology is bringing wound management through advanced wound photography. These apps are often embedded into the EMR and they have the ability to auto measure the wound with accuracy never obtainable at bedside with a ruler and flashlight"

Incorporating photographs as a standard in wound management has the ability to improve wound type accuracy, provide a focal point for teaming, and increase overall transparency of the true state of chronic wounds. However, this is not to imply that this is a new idea, in fact, those in wound management have went to great efforts to incorporate, even with the use of polaroid camera’s in the past. However, the challenges with incorporating routine photography has been standardizing the technique, adequate lighting to depict a true image, infection control of the camera, privacy and use of the photo, consent of the photo, storage capacity within electronic medical records and or the integration of a printed photograph into the medical record. Further, the possibility of a photograph that could imbed technology to monitor the wound overtime, to auto measure, to become a team-aid, and that could create enterprise reporting had not been fully recognized until recently.

Today, new wound app technology is bringing wound management into mainstream care through advanced wound photography. These apps often are embedded into the EMR or can be downloaded into the individuals EMR. They have the ability to auto measure the wound with accuracy never obtainable at bedside with a ruler and flashlight. Storage capacity, privacy, and technique have all been solved for. Further, facility or enterprise data and reporting can underscore system-wide readiness and better identify programming opportunities for particular wound types with a population health perspective. Lastly, and most importantly, the photograph raises the bar with wound type accuracy and a team approach. As a wound specialist now for almost 3 decades, I have supported efforts to standardize photo apps as an evaluation wound tool in long-term care. This to me is one of the most exciting innovations in care that not only is improving teamwork and outcomes it may just make wound care somewhat cool!