By Stephen Doades, VP eKare Europe BV and Lucy Champ BD Director, eKare Europe BV
Chronic wound care is a complex and rapidly evolving field that presents significant challenges for healthcare professionals worldwide, including those in the United Kingdom. According to Julian Guest’s latest report, there were an estimated 3.8 million patients with a wound managed by the NHS in 2017/2018. The annual NHS cost of wound management was £8.3 billion, of which £2.7 billion and £5.6 billion were associated with managing healed and unhealed wounds, respectively. 81% of the total annual NHS cost was incurred in the community.
In recent years, the use of digital systems in wound care has become increasingly popular, with the National Wound Care Strategy endorsing the use of digital technology to support wound care management. Dr. Una Adderley, National Wound Care Strategy Programme Director, has emphasised the importance of embracing digitalisation across the entire care pathway.
“We are convinced that improving wound care in a sustainable way cannot happen without the implementation of point-of-care (POC), NHS compliant mobile digital technology (with digital imaging) capable of interfacing with other essential NHS data systems. Such systems will facilitate integrated care and support quality improvement by providing data feedback to inform and tailor service provision to local needs. It will also improve clinical care by providing high quality clinical information to clinicians and patients,” states Dr. Adderley in this recent article.
eKare inSight: A Wound Management Digital System
The eKare inSight ® platform is one of the wound management digital systems (WMDS) supporting the National Wound Care Strategy.
ekare inSight is a cloud-based platform that enables healthcare professionals to manage wound care effectively, with its backbone born from clinical research where accuracy, documentation and data are fundamentals. The system provides real-time access to patient data and wound assessment, imagery, measurements and treatment plans, thus allowing healthcare professionals to streamline the wound care process.
By working with several of the first mover sites in the UK who have been guided by the National Wound Care Strategy digital arm, the eKare inSight system has been developed into a UK Wound Management Digital System. Key elements to this include:
- Alignment and concordance with the National Wound Care Functional Specification
- Adherence to the UK required standard relating to data security;
- Data Security & Protection toolkit
- Cyber Essentials
- Digital Technology Assessment Criteria (DTAC)
- GDPR
- Additional UK & NHS specific requirements
- Data capture, which has been aligned to the various national requirements such as CQUIN and National Woundcare Metrics, along with local requirements to replicate existing templates on EHR enabling true mobile data capture and removing duplication
- Interoperability with Electronic Health Records (EHRs) and other data sets such as CSDS via utilisation of SNOMED coding
- Dashboard and Reporting functions enable quick views on caseloads, healing rates, performance, activity, and metrics, all of which are geared to enable clinicians to understand data at the touch of a button.
Wye Valley Tranche Site Adopts inSight
Lucy Woodhouse is Service lead for Wye Valley, one of the National Wound Care first move sites. She references her journey adopting the eKare inSight Wound Management digital system.
“We were selected as one of the National Wound Care first tranche implementation sites and chose eKare inSight as our Wound Management Digital System. This decision was mainly based around the user friendliness of the system from a clinical user perspective and the fact all requirements of the NWCS functional spec were in place along with the raft of standards needed.
What was important to us at Wye Valley was the understanding of Wound Care and the flexibility to ensure the system worked for Wye Valley. We have been very fortunate to have been a key part in developing the system not just for us, but for the wider UK.
Adoption of the WMDS was not without its challenges as often the case with change and adding technology into the frame makes it interesting, but with the team focused on the end goal and the support of the eKare team we overcame the challenges and adoption is very strong.
We are now in a position with a system that works for us enabling us to deliver in accordance with the National Wound Care Strategy objectives and importantly gives us fast visibility on not just Metrics / CQUIN but data that we just never had the access to prior which is enabling us to challenge our wound care organisations and see the benefits.”
Whilst often the benefits for such a system or intervention are seen, often clinicians are dealt with the hard work, and sometimes struggle, to see the benefits. Engagement with clinicians was an important part of the adoption of the WMDS. Below Alison Barker – Lower Limb Specialist Nurse and Team leader details some of the impacts for her and her team:
- Improved Communication. From a system benefit perspective, using eKare inSight quickly lead to us identifying that some wounds were not being seen by the correct team, eKare therefore assisted in prompting discussions between teams and improving/forging relationships with podiatry and delivery of further training to all to ensure the pathway was followed every time. Patients with foot wounds now get seen by the most appropriate caregiver ASAP without delay. Likewise, it can show hot spots of practice and any areas that needs improving.
- Better Visualization: We have the full history of the episode of care at our fingertips when we are with the patient, including simple visuals.
- Consistency and Time Saving: Time is saved, and variation removed because we all use the same simple, concise template on the app at each patient review/assessment and it requires us to write much less in free text. We also feel our documentation is more robust and less ambiguous.
- Better Referral / Transfer: It links to the requirements of the Lower Limb CQUIN and the National Wound Care Strategy Metrics so we are able to run the necessary reports with ease. We have data that we have never had before. We have been able to show a reduction in infections, more appropriate use of anti-microbials and a reduction in admissions associated with cellulitis of the lower limb for example.
- Improved Patient Engagement: We can use eKare when making onward referrals or seeking opinion (e.g. Vascular and Dermatology) The person receiving the referral can see the documentation of care to date, along with photographic evidence and chronologically, the dimensions and colour composition of the ulcer represented graphically.
- Convenient, Secure Data Access: All health care professionals can view the data, either directly from eKare or from within our electronic patient record system (EMIS It has helped us to engage better with patients. The photographic evidence of their ulceration and the healing trajectory graphs clearly show improvements (or otherwise), which in turn helps with concordance as it shows very simply the treatment is working
Patient Case Study
Mrs J.G., an 89 year-old female with a leg ulcer to the lower gaiter area of the left leg. The ulcer had been present for around 12 months prior to her coming to Lower Limb clinic. On presentation to us she was fully assessed, a Doppler done, and the necessary compression applied. Mrs J.G did struggle with concordance to their compression treatment because they felt that it was not 9 achieving any benefits or results. They weren’t confident that their wound was improving. We began to use eKare inSight to digitally document wound assessments, image and measure their wound. eKare inSight proved to be a great visual aid for both the health professional and patient. It allowed us to easily look back at photographs and treatment plans and adjust accordingly. We were able to share the relevant information with Mrs J.G. For the first time, Mrs J.G. was able to see a clear picture of the progress of their wound from the photos and the healing trajectory graphs. They were able to see that their ulcer was healing! This really improved their understanding, through pictures, of how compression does help to heal the ulcer. The patient became highly motivated to persevere with their compression treatment. They involved their partner who could also see the healing and understand the treatment rationale and provide support and encouragement. The ulcer healed within 6 months of presentation to the lower limb team and Mrs J.G. is now able to self-care applying her own cream and daily wrap.
For us at eKare, we are seeing many examples of digital transformation taking place and aiding wound care within the UK. It is exciting to see many organisations embracing and leading the transformation.
Follow us on social channels to hear more examples of how we are supporting clinicians embrace digital transformation within Wound Care. For more information contact info@ekare.eu
About the Authors
Stephen Doades, VP eKare Europe
Stephen Doades is an experienced commercial leader who has spent the past 20 years working in the global Healthcare/MedTech industry. He has held leadership positions in companies of all sizes, ranging from startups to multinational corporations, across the US, Europe, and the Far East. With a focus on sales and marketing, market access, and commercialization, Stephen brings a deep understanding of the unique challenges and opportunities in the healthcare industry, particularly within the NHS. Stephen Lives in Cambridge UK.
Lucy Champ, BD Director eKare Europe
Lucy has 15+ years’ experience managing business development and marketing strategies for various multinational medical companies. Working with NHS and corporate partners, Lucy has developed, implemented and supported numerous projects focussed on pathway and service re-design to release resource and promote improved patient outcomes. An anatomist by training, Lucy graduated from The University of Liverpool in 2005 with First Class Honours in Anatomy and Human Biology. Lucy has been with eKare since the inception of their journey in the UK and Ireland.
