A Novel Point-of-care Solution to Streamline Local Wound Care Formulary Development/Management, and Promote Cost-effective Wound Care

Background: Local dressing formularies reinforce use of clinically appropriate and cost-effective products. Despite its importance, many clinics postpone their decision to create/update their formularies, as the process of creating/maintaining a formulary is a multi-step approach that is discouraging to most clinicians. Furthermore, the traditional intranet/print formulary formats limit point-of-care access and interdepartmental dissemination. We aimed to create a solution to overcome obstacles in formulary development/implementation/management. 

Method: Using the Design Thinking methodology the solution was developed as a module within a clinical/reimbursement decision support web-application* for wound care and hyperbaric clinicians, as follows: 
●    Clinician needs/desired features were identified through interviews. 
●    The module was developed with robust programming language♥, library♦, framework♣, and APIs❖. 
●    Module was implemented at a hospital-based outpatient wound clinic, together with the local clinical team:
      ○    Products used by the clinic were identified/”favorited” among ~1000 product profiles stored in the module. Selected products were automatically categorized and listed in groups (e.g, alginates, foam), to facilitate comparison
      ○    Guided by the web-application’s evidence-based content, interactive feature matrices and virtual advisory panel, clinicians chose products with best fit, eliminating redundancy within each product category
      ○    Clinic added custom instructions/educational notes to each product, to serve as staff quick-reference manual. 
      ○    Clinic shared formulary link with partnering institutions (e.g.home-health agencies).

Results: The module streamlined/simplified development/management of local wound care formulary through automatic product listing/categorization/grouping, immediate access to critical formulary decision-making information, product-specific customized notes, and real-time interdepartmental collaboration. The process resulted in a 36% decrease in the number of products (from 67 to 43 across 22 categories), and inventory cost savings of 7%(US$35,888/year).

Conclusion: A solution to streamline local wound care formulary development/implementation/management was developed. Implementation resulted in inventory cost savings and increased staff efficiency. Its ease-of-use may significantly increase adoption of cost-effective formularies and maximize health outcomes.