Wound care
smartphone app developed to simplify wound tracking and documentation. Established in 2014, the company’s founders – a team of biomedical engineers at Johns Hopkins University – set out to help tackle what they diagnosed as the two biggest problems facing hospital-based wound care. The first, as Kevin Keenahan, co-founder and CEO, explains, “is that clinicians use rulers to measure wounds, and that introduces a lot of error when looking at outcomes”. And the second is that “those outcomes […] are communicated between different electronic medical record systems that don’t talk to each other, or that don’t make it easy to share outcomes or care plans. So wound care tends to exist in these silos”. So, Tissue Analytics was born: a user-friendly app that allows both clinicians and patients to accurately measure wounds and render the data captured legible across a range of electronic medical record (EMR) systems. Unsurprisingly, perhaps, the pandemic has brought about a spike in the use of such technologies. “During the Covid pandemic, [the situation] was rather challenging and many wound centres shut down in the US,” Oropallo says. In order to stay open for patients, many staff at these centres had to work remotely, using telehealth to bridge the physical gap. “Tissue Analytics was a company that we [had been] entertaining for a while, but in a large corporation like this […] it wasn’t deployed yet. During Covid we were able to accelerate the wish- list,” she explains. Using Tissue Analytics – in conjunction with telehealth service provider Avizia (which merged with Amwell in 2018) and EMR system Allscripts – Oropallo was able to keep Northwell’s vital wound care centre open throughout the pandemic. Yet she also recognises that there are significant limits to the widespread adoption of the technology. “The biggest challenge is that not all patients have good accessibility to smartphones, nor do they know how to use them. Some of the companies like Tissue Analytics were not equipped to really understand the intricacies of the difficulties of patients understanding how to do this. I mean, the majority of our patients are over 70.”
Breaking barriers To help combat these obstacles, Northwell has rolled out an initiative to inspire younger and more tech savvy family members to participate in care. This is a refreshing example of technology building a bridge, not a wall, between generations – helping to facilitate, rather than erode, face-to-face interactions. For every obstacle that telehealth presents, another door, it seems, opens under its far-reaching remit. As Oropallo points out, telehealth has granted clinicians access to previously unseen
Practical Patient Care /
www.practical-patient-care.com Is telehealth the future?
Early in the Covid-19 pandemic, telehealth usage surged as consumers and providers sought ways to safely access and deliver healthcare. According to data collected by McKinsey & Company, overall telehealth utilisation for office visits and outpatient care in the US was 78 times higher in April 2020 than in February. The spike came at a time in which many healthcare professionals were using telehealth as their first line of care, only seeing patients in person if it was absolutely. McKinsey conducted a review of this research in July 2021 and reported that although these levels stabilised, telehealth utilisation was still 38 times higher than before the pandemic. In a consumer survey, it also found that 40% of respondents were willing to use telehealth services – a dramatic increase on 11% prior to the outbreak of Covid-19.
McKinsey also looked at doctor’s attitudes to telehealth and found that 58% viewed the modality more positively than they had before the pandemic.
aspects of patients’ lives. “We only get one picture: their picture,” she comments. “But [with telemedicine] we would really have a full understanding and comprehensive view of the patient. So, [their] economic status, where they live, their food source. Many times we may treat them, but they go back home and their social environment might be difficult [and then they have to] come back to the wound centre because they’ve had another traumatic injury. So I see the technology of the future as one in which the wound care physician will have those other aspects to think about, besides just managing the wound.”
“The cat’s not out of the bag yet, but I would advise somebody who’s going into this area of telehealth to embrace it. This is really going to be the future.”
Dr Alisha Oropallo, Northwell Health
Will telehealth continue to expand after the pandemic? For Oropallo, Al Rubaiay and Keenahan, there’s no question that the future of healthcare lies in telemedicine – but the balance for best practice remains to be determined. “We’re working on a best practice [paper] to try to evaluate our telehealth right now,” Oropallo explains. “We’re looking back over the past year [to see] how many times we made the right judgement over the phone, talking with the patients, and how many we didn’t […] and they ended up at the hospital. So the cat’s not out of the bag yet, but I would advise somebody who’s going into this area of telehealth to embrace it. This is really going to be the future.” With all the caveats and cautions, there’s no question that telemedicine will be playing a key role in the roadmap of the future – but somebody should probably do something about that old- fashioned name. This is so much bigger than the telephone.
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