Home Health and Wound Clinics; A Complicated Relationship

Intro: Dedicated, brick and mortar wound clinics have been a part of the specialty provider landscape for more than two decades (Shah, 2011). The reality that wound clinics may rely heavily on a robust Home Health Agency (HHA) clinical response for supply procurement, dressing changes, case management, disease state management, vitals/sepsis monitoring and multidisciplinary support can be cause for concern.

Method: This retrospective study was conducted to investigate the potential quantitative effects to patients and HHAs who had wounds co-managed by a wound clinic (WC) and those who had wounds managed primarily by the agency’s wound and ostomy team (WOT). The subsequent control group (CG) were patients that had diagnoses of wounds and wound documentation in the Electronic Medical Record (EMR). The agency EMR and Electronic Data Warehouse (EDW) and supply vendor were used for analysis of patient data. Results: A reduction in average wound surface area was calculated by comparing the earliest wound measurements and the latest wound measurements (CMS episodes of care; 2020-2021) and revealed as follows: CG 50% reduction, WC 46% reduction, WOT 70% reduction. Average cost of supplies per episode were calculated using available vendor data and revealed as follows: CG $184.33, WC $267.57, WOT $237.48. Average billable visits per first period were calculated using agency EDW and revealed: CG 12.45 visits, WC 9.64 visits, WOT 12.70 visits.

Discussion: The results revealed a marked improvement in average surface area reduction in the WOT group and may be attributed to the agency’s commitment to ongoing touchpoints (secure live video, phone and email consultation) by the field clinicians and wound team specialists.