Specialisation is a growing trend in the US healthcare industry, as is the use of ever-more-sophisticated telemedicine applications. Six-year-old Wound Technology Networks has built a business taking advantage of both.
Through the use of web conferencing and call centre applications, which WTN medical professionals can access via Verizon’s wireless IP network, healthcare providers can cut their operating costs while improving the care of wounds.
“The treatment of wounds has never been very efficient, and our system makes it more consistent and more effective,” says George Pollack, chief operating and technology officer at the specialty Florida-based medical practice.
By providing consistent clinical care via its network, WTN has reduced typical patient-healing time by 50%, cut down on patient readmissions by 95% and also successfully treats patients 91% of the time, says Pollack, who is a doctor-turned-IT specialist.
The business of healing wounds
Every day, millions of individuals either fall, become diabetic or develop problems with their veins. The result is a bevy of wounds requiring stitches, short-term care or long-term treatment. Administering to such wounds is a time-consuming and costly process for healthcare providers: US providers spend US$20 billion to $25 billion (NZ$38 billion) per year treating chronic wounds. And that number has been rising, according to Lisa Gould, a professor at the University of Texas Medical Branch.
Treating a simple cut is fairly easy, but providing services for a complex wound or someone with diabetes can be difficult and expensive — a problem that is expected to become worse.
“As the population ages, the number of patients requiring wound treatments is increasing significantly,” says Jeffrey Galitz, CEO and chief medical officer at WTN.
Often, generalists who work at emergency rooms, clinics or doctors’ offices end up treating such wounds. Consequently, the effectiveness of treatment is becoming scattershot. Patients often take longer to heal than necessary and some develop other problems, such as infections.
For more effective treatment, WTN delivers more support materials to its doctors, nurse practitioners and nurses than those typically available when treating a wound. As the WTN specialists provide care, they can tap into a corporate web server for help identifying the type of wound, the proper treatment, the correct way to administer that treatment, descriptions of the healing process, best practices and the like, Pollack says.
WTN says it has developed the world’s largest wound-care database. It contains 75 data points on 200,000 treatment types, it says. Healthcare product suppliers Johnson & Johnson and 3M, for example, provide step-by-step directions on how to apply a new dressing, thus increasing the likelihood that WTN specialists will use their products properly.
“Healthcare products have become more complex — some dressings stay on for weeks rather than days — so more care is needed when they are applied,” says Pollack.
Network-based consultations
WTN’s 41 healthcare providers consult with one another via voice or multimedia web conferences. During each procedure they can connect to the company’s call centre and talk to fellow healthcare practitioners about each patient’s diagnosis and treatment. For instance, the group can examine a snapshot of a wound and determine the most effective treatment. Half a dozen or so medical professionals staff the call centre, Pollack says.
To support these conferences, WTN has built a sophisticated network using Polycom’s PathNavigator call-processing server, PVX video-conferencing software and Logitech web cameras. Calls are carried over Verizon’s third-generation, Enhanced Data GSM Environment-based wireless IP network. Previously, WTN used Cingular’s Code Division Multiple Access-based cellular data service, having earlier upgraded from the traditional telemedicine service, ISDN, to achieve ubiquitous coverage. In its US$170,000 migration to the Verizon wireless IP net, WTN tripled available bandwidth and now enjoys speeds of 384kbit/s.
For security, and to be in compliance, WTN uses SonicWall’s Pro 5060 firewall/VPN appliance and NetMotion Wireless’ Mobility XE mobile VPN server.
Proven effectiveness
Another plus of WTN’s network-based approach is that treatment data is entered by call centre staff who record the steps taken. “One of the problems doctors face is they are now forced to spend a lot of time filling out paperwork and that cuts into the time they can spend interacting with patients,” says Pollack.
“Because our system relieves doctors of many of those responsibilities they can treat more patients.”
In addition, wounds can be treated in more locations. Wound patients can receive treatment at WTN clinics or in their own homes, at assisted-living facilities or at physicians’ offices.
As well as overcoming technical hurdles, WTN has faced business challenges, such as getting healthcare insurers to recognise its work as it has built up its business. Insurers such as Humana Health Care, Medicare, Medicaid and United Health Care will now pay for patients that the company treats. And no wonder: patients heal more quickly so insurance companies benefit. They save as much as 85% on their wound-treatment bills, WTN reports.
WTN is now extending its reach. “Recently, we expanded our business, so we are working with healthcare providers in California and Nevada, as well as Florida,” Pollack says. The company operates nine clinics in Florida, two in Las Vegas and two in California, and supplements those offices with mobile healthcare professionals.
WTN expects its work to serve as a model for other healthcare providers. “To date, telemedicine applications have focused on serving rural areas,” Pollack says.
“We think the potential benefits are just as significant, perhaps even more significant, in densely populated urban areas.”
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