Unwired to heal: telemedicine improves treatment

New venture uses networking to facilitate long-distance healing

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.”


Kansas City Power & Light

- Broadband microwave brightens outlook

Facing application-performance issues, the IT team at this Kansas City Power & Light knew it needed to address bottlenecks created by the ageing 6GHz licensed digital microwave network that connected power plants, substations and corporate locations. It found the answer in a specialty broadband wireless system from Orthogon Systems (now Motorola).

The OS-Spectra Ethernet bridge provides point-to-point connectivity in near- or non-line-of-sight environments. For Kansas City Power & Light, the microwave system has boosted throughput from 1.5Mbit/s to 100Mbit/s, enabling the utility to support new business-critical applications, such as internet access, multimedia and VoIP. Since the project was completed earlier this year, managers report more timely access to reporting data, and business units are developing new applications that would not run efficiently on the old network. The utility invested US$950,000 (NZ$1.4 million) in the broadband wireless system.

Vassar Brothers Medical Centre

- Going wireless eases communication pain

Employees at Vassar Brothers Medical Centre, in Poughkeepsie, New York state, had been spending a lot of time trying to connect with one another as they roamed hospital floors. With the implementation of InnerWireless’ medical-grade wireless utility, hospital staff can now connect with one another instantly.

The new wireless infrastructure, built on a broadband antenna system that carries radio frequency signals, accommodates a broad range of wireless services including two-way radio, paging, cellular and wireless LAN. At Vassar Brothers, the US$3.2 million (NZ$4.8 million) upgrade has significantly improved employee productivity, among other benefits. For example, the medical centre reports reducing the amount of time spent trying to find the right staff members by 85 minutes per nurse, per shift, as staff no longer need to sit by the nursing station waiting on physicians to return calls or to answer the nurse-call system.