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Wound care is complex, chronic and demands a coordinated, technology-enabled approach

June 29, 2017 
By: Carol Murdock, Healogics, chief marketing officer

At Healogics, we work every day to advance the art of wound healing. Last week’s New England Journal of Medicine review article, Diabetic Foot Ulcers and Their Recurrence, offers a real-life picture of the challenges and complexities of chronic wound treatment. For those of us in the wound care industry, it serves as a tool to explain the important work we do. As a Healogics employee, it makes me more confident than ever in our technology-enabled approach to wound care,[i] as it validates two market beliefs that are influencing the strategic direction of our company.
 
First, that the dangers and complexities of diabetes-related foot ulcers are underappreciated by payers, consumers and even healthcare providers.

These ulcers often go untreated until an acute episode—likely an emergency room (ER) visit, hospitalization or amputation. The statistics are sobering:
 
  • Foot ulcers among people with diabetes are not rare. In fact, between 19% and 34% of people living with diabetes will experience a foot ulcer and lower extremity-related wound costs are an estimated $58 billion every year—more than many common cancers.
  • The risk of death at 10 years for a patient with diabetes who has had a foot ulcer is twice as high as the risk for a patient who has not had a foot ulcer.[ii]
  • Untreated foot ulcers are the number one cause of non-traumatic amputation in the U.S. Once amputation is experienced, the likelihood of mortality among people with diabetes exceeds 70% within five years.
  • One recent U.S. assessment of 785 million outpatient hospital visits by people with diabetes between 2007 and 2013 suggested that diabetic foot ulcers are more common reasons for ER and hospital admissions than congestive heart failure, renal disease, depression and most forms of cancer.
 
Second, wound care, specifically the treatment of diabetic foot ulcers, should be viewed by providers, consumers and payers as chronic.
 
  • Patients often undergo months of therapy, sometimes a year, to rehabilitate their foot.
  • Unfortunately, even after the resolution of a foot ulcer, recurrence is common – and diligent follow-up is necessary.
  • Based on 19 studies, roughly 40% of patients have a recurrence within one year after ulcer healing and, at three years, the rate is almost 60%. The treatment regime is more akin to cancer than any acute care episode.
  • The researchers themselves suggest that “it may be more useful to think of patients who have achieved wound closure as being in remission rather than being healed.”
 
The reoccurrence numbers alone demand that we reorient the system to treat diabetic ulcers specifically as a chronic symptom of an underlying condition that requires ongoing specialty care.

The complex, multi-specialty clinical orchestration needed for chronic wound care, such as diabetic foot ulcers, can only be achieved with an evidence-based, technology-enabled approach.

As the healthcare system evolves from fee-for-service to value-based payments, it will be even more important to quantify, validate and standardize the definition of quality wound care. At Healogics, we are leading the way to quality, evidence-based wound care with our intelligent, data-and metric-driven technology platform. The Healogics WoundSuite platform is the central hub for our patient-centered wound care approach. It keeps Wound Care Centers® connected and coordinated with other sites of service enabling continuity of care across inpatient, skilled nursing facilities and home. The scalable platform enables personalized patient care programs and confirms that each procedure and/or technology is delivered through the right channel, at the right time for the patient, ensuring the best possible outcome.
 
Chronic wound care for diabetic foot ulcers may be underappreciated by many in healthcare, but it’s not by Healogics. We thank Dr. Armstrong and his colleagues for this article, which helps elevate the critical need for specialty, connected wound care.
 
[i] All original sources for the statistics can be found in the review article.
 Armstrong, D. G., D.P.M., M.D., Ph.D., Boulton, A. J., M.D., & Bus, S. A., Ph.D. (2017, June 15). Diabetic Foot Ulcers and Their Recurrence — NEJM. Retrieved June 21, 2017, from http://www.nejm.org/doi/full/10.1056/NEJMra1615439
 
[ii] 16. Iversen MM, Tell GS, Riise T, et al. History of foot ulcer increases mortality among individuals with diabetes: ten-year follow-up of the Nord-Trøndelag Health
Study, Norway. Diabetes Care 2009; 32: 2193-9. 17. Skrepnek GH, Mills JL Sr, Lavery