Frequently Asked Questions

What were the factors that lead to the development of WoundVision?

    When considering the vast array of dynamic variables at play in medical situations it is no surprise that the health of a patient can be compromised due to the complexity involved with sorting through all of the variables.  The identification, diagnosis, tracking and management of pressure ulcers can be among the most complex issues involving patient care today. Data collected about the patient includes multiple attributes and is obtained from multiple data sources across several facility sites spanning several acuity levels across multiple time series. Too much information and no reasonable way to formulate and deliver answers to the bedside of the patient in a manageable, quick and accurate way are daunting problems faced universally by care givers.

    The WoundVision solution focuses on how multi-source, multi-attribute information related to pressure ulcers can be integrated, analyzed and fitted for a particular situation, and hence how results and an effective care plan can be extrapolated based on the analysis of that data. Our approach utilizes predictive modeling in combination with thermographic imaging assessing the patient’s individual medical situation through the integration of obtained information and the analysis of all related data sources. Additionally, the WoundVision solution is utilized bedside, at the point of care…those few face-to-face minutes where a clinician needs to quickly use all available medical information to make a critical determination of the direction of care for their patient.

    In practice, clinical judgment exercised by a clinician in the choice of treatment for an individual patient is based to an extent on theoretical considerations derived from an understanding of the nature of the illness. But it is based also on an appreciation of statistical information about diagnosis, treatment and prognosis acquired either through personal experience or through medical education. The important argument is whether such information should be stored in a rather informal way in the clinician’s mind, or whether it should be collected and reported in a systemic way. No clinician – no matter how thorough and intelligent they may be – has the ability to acquire by personal experience, enough factual information over the entire range of medicine to be able to do what can be done with technology and statistical models. And it is partly by the collection, analysis and reporting of statistical information that a common body of knowledge is built and solidified. The truth is that the amount of on-hand knowledge needed in order to deliver appropriate care and treatment has become so vast that even highly specialized clinicians have trouble keeping current with new information germane to their professional area of focus.

    Using predictive modeling is a comparatively new area of activity involving the marriage of ideas from various disciplines, and is an essential and inseparable part of all scientific activity. Any system starts with a problem domain and a conceptual model of how to execute a solution. The WoundVision solution provides additional, invaluable competitive strength by utilizing a revolutionary combination of predictive modeling, thermographic imaging and a clinician’s medical expertise to positively impact their patients’ outcome.

    With the WoundVision solution, the data garnered from these refined predictive models and images is implemented into a system that gives clinicians the freedom and confidence to authorize treatment to their individual patient needs under the art of medicine, as well as satisfy the implementation of data with the powerful application of mathematics/statistics.

    How do you think Woundvision will alter the current landscape? How will it impact the Wound Care industry?

      Even the vast amounts of data being collected through the healthcare system -- which could provide facilities with some pathway to reaching out ahead of the problems with accurate risk assessments and preventative care -- is falling short in application. If clinicians don’t have sensitive enough assessment tools, they cannot accurately assess a patient’s care/treatment needs in a timely manner, resulting in a failure to match up patient acuity levels with effective care and accurate reimbursement. This is the very essence of the pressure ulcer and wound care crisis.

      Existing risk assessment tools are inadequate because they only use sums of the variable without taking into account the interaction of all the variables and how their weights factor in to the outcome of the sum in part because they were developed years ago and do not utilize current technology. These tools have many limitations, including the following:

      • They usually weight each risk factor equally, when in fact certain responses are far more predictive of risk.
      • They do not capture resident history, e.g., the cumulative effects of chronic conditions and diagnoses that contribute to risk.
      • They fail to weigh interactions of smaller risk factors that add up to high risk.
      • They fail to account for non-linear relationships between predictors and outcomes.

      The WoundVision solution provides multiple benefits to all parties involved. Unlike any other solution on the market, the unique combination of the standardized questions in combination with the proprietary imaging system can provide a holistic view of the patient’s overall health and related trends over time. Some of the intrinsic benefits of the WoundVision solution are listed below:

      • Allows the clinician to get to know the patient proactively
      • Provides essential knowledge bedside
      • Allows a physiologic approach to the patient
      • Is highly educational – community/family/patient
      • Creates research opportunities – future capabilities
      • Provides comprehensive documentation
      • Fulfills coding requirements
      • Provides unbiased standardization
      • Assists in evaluating care plan analysis
      • Supports meaningful use of EHR
      • Allows valuable seamless continuum of care

      In this time of diminishing healthcare dollars available to apply to each healthcare need, precision tuning of the system that officiates that process – the risk assessment – is critical. That’s where the WoundVision imaging solution comes in: our solution accurately matches acuity levels with reimbursement dollars, providing an instant, highly specific and sensitive risk assessment at the point-of-care.

      How will WoundVision positively impact wound care expenditures?

      According to the Journal of Wound, Ostomy and Continence Nursing, an average hospital incurs $400-$700 thousand dollars in direct costs to treat pressure ulcers annually. And a recent National Pressure Ulcer Advisory Panel whitepaper states that 87% of verdicts and out-of-court settlements relating to pressure ulcer litigation are awarded to plaintiffs. The average settlement for wrongful death suits involving pressure ulcers is approximately $250,000. This situation begs the development of a solution that will allow both the patient and the healthcare facility an opportunity to avoid wound treatment expenditures whenever possible.

      Accurate and quick clinical application of data is a powerful tool and can provide a measurable improvement in the quality of life, the length of life, lower mortality rates and lower, more precise and relevant reimbursement costs to the government and insurance companies. Where the individual patient is concerned, through validation in a large prospective series, predictive models can be implemented in a clinical setting for improved patient selection based on a patient’s individual medical profile and specifically tailored to the level and breadth of their clinical acuity. This would lead to better quality of care for patients and optimization of resource allocation for healthcare facilities and lower, better defined insurance claims.

      What are other potential applications of your solution?

        Since the same analysis performed to predict and track pressure ulcers and wounds is a core quality indicator for determining risk of many other issues including falls, dehydration, malnutrition, and the like, the WoundVision system is probably applicable across the entire continuum of care.  WoundVision is focusing initially on the long-term care market followed by the hospital market.  Home care and specialists such as wound care clinics are also strong candidates for the WoundVision solution. 

        The WoundVision system is extremely pertinent in today’s healthcare provider market given the focus of healthcare regulators on rigorous documentation and increased scrutiny by the CMS on reimbursement related to wound care.  For example, if a patient admits into a hospital and presents with no visible wounds but later develops a pressure ulcer, the hospital has to absorb the cost of that treatment even if the pressure ulcer was unavoidable.  The WoundVision system enables healthcare providers to identify wounds before they present visually so that treatment can begin more quickly while also enabling the facility to receive proper reimbursement for wounds when possible.  This is just one of a number of examples that are driving facilities toward adopting WoundVision.

        Are there any clinical trials or beta tests that illustrate the value of WoundVision to patients, physicians and the healthcare industry as a whole?

        The WoundVision team recently conducted a beta test with a trans-facility Midwestern healthcare group. Data was collected using a comprehensive spectrum of variables (questions) developed from this established knowledge. Clinicopathological data that was tracked was divided into categories:  demographics, mobility, nutrition, continence, cognition and general medical. The results of our data collection show extremely promising statistics in early detection of pressure ulcers. Furthermore, we believe that our study did not only help the community become better informed about the development of pressure ulcers, but also provided clinician’s with insight on how to avoid, prevent, and reduce the onset of wounds and other important health factors providing a holistic view of a patient’s health. The initial study results below are representative of an initial group of 195 patients.  The population of patients in the study has expanded to more than 500 and the data from that broader test is being compiled.  As expected, the predictive capabilities of the system have continued to improve over time. 

        Results:

        Enrollment of August 1, 2009

        • 195 patients (consented)
          • 23 participants withdrew
            • 13 withdrew due to loss of interest
            • 5 deceased
            • 5 healed wounds

         Participating facilities (for continuing patient study)

        • Ohio Hospital and surrounding long term facilities

        Adverse effects (negative impact on patients)

        • None

        Benefits

        • Improved quality of care
        • Improved documentation and tracking of wounds
        • Improve wound management/healing
        • Improved outcomes
        • Decreased cost levels for treatment of wounds related to early detection
        • Consistent routine imaging
        • Documentation and records utilized for tracking of changes in patient condition
        • Community and patient education
        • Family participation and care
        • Staff education and participation
        • Individual tracking of skin
        • Student participation (Master-level nursing) in research program
        • Increased socialization for patients

        Our program of using predictive modeling and imaging resulted in extremely high percenttages of accuracy for predicting pressure ulcers in patients who had the propensity for wounds:

        • Sensitivity = 82.35%
        • Specificity = 98.31%
        • Geometric mean of sensitivity and specificity = 89.98%
        • Positive Predictive Value (PPV) = 82.35%
        • Negative Predictive Value (NPV) = 98.31%
        • Geometric mean of PPV and NPV = 89.98%

        By enrolling, following and tracking patients, we improved our capability of identifying patients who were at risk for developing pressure ulcers – either via data collecting or through image processing.  Through the combined method that we have developed in our research, we were able to accurately predict the development of a pressure ulcer with a Geometric mean of PPV and NPV of 89.98% and with an area under ROC curve (AUC) of 0.935228 – in contrast to the current method, which was scored within the Regional Hospital’s facility, and yields an effective Braden risk score of Geometric mean of PPV and NPV of 28.79% and with an AUC of 0.694286. Such a significant improvement in accuracy underlines the importance and validity of the WoundVision solution for use in healthcare facilities worldwide.