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Diagnostic Devices: Welcome to the Future
Dear Readers:
For those of us old enough to remember the excitement of purchasing our first mobile flip phone, we recognize the excitement surrounding the advent of digital imaging technologies for wound assessment. After more than 20 years since purchasing those first flip phones, most of us would be challenged to make it through the day without our trusty digital companion. It is quite possible that 20 years from now, our twentieth-generation smart phone could include a single wound assessment application—and younger generations of providers will not be able to imagine how we treated patients without it. (Imagine a child’s reaction after explaining how you once used a library for research.)
Over the past 2 to 3 years, the wound care space has started to develop some truly fun and potentially groundbreaking technologies. Whether it is a device that can look at the biofluorescence of bacteria, the perfusion to the wound, objectively quantify the appearance of the wound bed, link to a real-time wound-tracking database, or one of the other novel diagnostic devices, they all have the potential to improve our diagnostic acumen and allow for decentralized care.
The wound care community should continue to validate these technologies and correlate their efficacy to improved outcomes. Once the relationship between these technologies and improved outcomes are established, providers would more easily be able to access the device for clinical use as well as reimburse for its use. There are some investigators who have incorporated these technologies into prospective randomized protocols by either validating the technology alone or in conjunction with other therapies; however, validating these technologies will take time.
We also must be careful that we assist regulatory bodies for setting the bar at the right location. We know that not all chest x-rays lead to a diagnosis of pneumonia—it is a clinical diagnosis that may have a positive chest x-ray; likewise, appendicitis can be diagnosed without a computerized tomography (CT) scan, but even the CT scan can miss appendicitis. Therefore, we must remember the diagnostic tests are just that—tests.
Much like moving from my mobile flip phone to a personal digital assistant (such as PalmPilot), I am excited when I use these technologies in practice and try to identify the best way to enhance patient-centric outcomes. Personally, I think many of us share this excitement over advanced technologies and developments emerging in wound care. It will be important to make sure we help guide a uniform pathway that leads to reimbursement for these diagnostic technologies. After all, reimbursement and utilization will bring us completely to the smart diagnostic pathway.
All providers should consider these devices. I would recommend trying them before they are fully developed to assess the devices and determine how they could be better.
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