Will Mobile Apps Bring Wound Care Technology to the "Cutting Edge"?

For wound care providers and other clinicians, 2017 continued to bring about a chaotic storm of health care reform based on quality measures, data registry requirements, and documentation standards. As has been previously stated in this journal, it remains to be seen if wound care practitioners will pool their limited resources and harness the power of their electronic health records to battle the “giant of healthcare reform.”¹ This country’s push to enact and substantiate quality of care delivery can be seen through the uniting of clinical practice with increasingly sophisticated digital technology that allows for more accurate documentation and communication. For good reason, the focus of this union is being placed on the perspective of the patient (ie, how the patient receives health care information). However, it is becoming increasingly clear that there is a need for clinicians to be armed with devices that more easily and effectively facilitate the means to that end. This article will discuss the proliferation of health care-related digital apps that are both patient and clinician focused in an attempt to lay a foundation for wound care clinicians to become more technologically savvy and clinically compliant. 

Today’s variety of digital healthcare apps can be useful for patient education and adherence, as well as for serving as treatment documentation tools. (A sampling of apps is shown in Figure 1). However, harnessing the incredible opportunity that specific apps can bring to the wound care industry space might be those that provide access to patient outcomes data. In the opinion of the author, mobile applications such as the TapCloud, eKare inSight 2.0, and Tissue Analytics could change the wound care space as we know it within the next 3 to 5 years. These apps are examples of those that aggregate important outcomes data (eg, patient-generated health data [PGHD], wound tissue data) into actionable insights with the ability to dramatically impact the quality of care being provided. In a time where quality, objective, and timely recorded documentation reigns supreme, these apps could be instrumental to the success of all wound care clinicians. It should be noted that currently, none of these apps are recognized by the Centers for Medicare and Medicaid Services [CMS] for the reporting of quality measure data as part of the Merit-Based Incentive Payment System [MIPS]. CMS does recognize the Patient-Reported Outcomes Measurement Information System for MIPS credit,² although none of these tools are specific to wound care. 

TapCloud is a comprehensive platform that covers more than 90 clinical conditions and connects patients and clinicians outside the clinical setting. Rather than biometric data, such as number of steps or blood pressure, the data focus is on how the patient is feeling (compared to yesterday). The platform has 2 parts: the patient app provides information to and collects information from patients, and the clinical dashboard synthesizes the large volume of individual data points and converts them into an easy-to-use visualization. The app was created as a way to capture the voice of the patient by collecting the right data at the right time to enable better health outcomes.”³ TapCloud’s platform provides care plans, reminders, and critical health information to patients. Through patent-pending technology, information about the patient can be gathered — information such as how the patient is feeling, presence of any pain or other symptoms, medication and care plan tracking, disease progression, medication side effects, historical behavior, and patient engagement.³

TapCloud then “translates” PGHD into usable information for clinicians, and visualizations enable rapid, effective clinician intervention (that is bilingual). In real time, clinicians can grasp what is happening with a patient, as well as potential contributing factors to their health status. Extensive research and engineering by the inSight 2.0 have validated overall system accuracy and reproducibility of 3D volumetric measurements. To that end, the inSight device has been shown to reduce intra- and interoperator variability while significantly reducing time to acquire measurements. Built to operate on an iPad and iPhone X, the mobile platform and its use should be familiar to clinicians. The app streamlines wound measurement, assessment, and treatment planning, and obtaining wound measurement is as simple as taking a photo using a tablet or iPhone X. The eKare inSight is a HIPAA-compliant cloud solution built on Aptible, an organization that seeks to help developers excel at data security and compliance. Through this app, users can safely share and analyze data with their care teams on a common platform to improve care coordination and patient-centered management.

Apps that provide PGHD are ahead of the projected 5-year curve in which such data will be relied upon more heavily; this means that using these apps will put wound care clinics, clinicians, and their practices ahead of that curve.⁴ Consider: 

• Patient outcomes data are directly related to the clinician’s practice, allowing for identification of key outcomes-related indicators, treatment insight, and patient adherence insight that clinicians can leverage to make adjustments within their own practice;

• Taking ownership of ample, viable opportunities to pioneer this industry vertically through partnerships that enable clinicians to work with apps and/or other technology developers to request inclusion of information, such as the U.S. Wound Registry’s MIPS-approved quality measures, directly within the app;

• Leveraging apps to harness real-world data to impact coverage based on proven effectiveness through PGHD;

• Utilizing PGHD apps to serve as clinician-listed “clinical practice improvement activities (CPIAs)” under MIPS. (Note: Specific CPIAs must be cross walked to the list provided by CMS and submitted to CMS through a qualified clinical data registry); and

• Leveraging the unique, broad, and diverse wound care specialty to serve as a trusted strategic partner for app developers, manufacturers, and industry at large.  

Currently, social media data analysis shows that healthcare practitioners are utilizing social media to communicate with their peers rather than leveraging social media as a tool to provide information to patients/caregivers and raise awareness of the wound care industry (see Figure 2). The wound care space is unique; thus, finding relevant or helpful information is difficult and, in turn, leaves patients and caregivers in a seemingly barren “patient-centered” digital landscape. To identify a viable point of entry in the social ecosystem for wound care, one can look to similar or “lookalike demographics” to better understand the manner in which that target patient demographic communicates and engages across the digital ecosystem. For wound care, the lookalike audience is the larger and overwhelmingly supportive chronic illness community (ie, #Spoonies). By engaging with this preexisting community, wound care can begin to carve its own niche presence. “Wound healing” search data, in comparison to the large volume of “chronic condition” search topic queries, show viable opportunity for engagement within the chronic illness community (see Figure 3). 

An omnipresent digital and social ecosystem will effectively direct patients and caregivers to educational information and raise awareness of the wound care industry to improve healing of chronic wounds and patients’ quality of life. The future-forward approach for wound care clinicians should be “app inclusive, social media inclusive, and digital presence inclusive.” 

Chrissy Stanojev is owner of PERMA Logix LLC, an organization specializing in the future of brand influence and connection strategy. She can be reached at chrissy@permalogix.com. She has no financial disclosures to report. This article was not subjected to the Ostomy Wound Management peer-review process.