Digitizing the Future of Wounds: What Are the Challenges? Editorial Summary The increasing burden of wound care is well established in evidence. It is essential for the clinician to be provided with the adequate tools to safely and effectively provide a high standard of clinical care to wound care patients. The deployment of the electronic patient record (EPR) has attempted to standardize documentation in care. However, it remains difficult to extract the suitable data required to provide evidence based medicine. An overview of the future of different digitizing wounds is explored in detail.
Introduction
T
he increasing burden of wound care is globally recognised. Many publications cite the rising economic costs and the rapidly increasing incidence of chronic wounds, and the impact that this has upon people and healthcare systems.1,2,3 Despite the increases in demand, the workforce required to deliver wound care is not expanding at the same rate; in fact, it appears to be contracting, driven by a global shortage of these professionals. Ousey et al. predicted a decline in the nursing workforce by 2016 due to reduced education commissions, attrition, rising retirements and net emigration of trained nurses.4 By 2020, 10% of community nursing posts in the UK were vacant.5 Given the mismatch between capacity and demand, it is vital to ensure that front line clinicians are provided with the correct tools to help manage these increasingly complex caseloads in as an efficient a manner as possible. Digital Wound Management Tools have the potential to achieve this.
Deciphering Wound Histories I qualified as a Podiatrist in 2005, and still recall with a shudder being presented with a large volume of paper records for patients that I had to visit that day. The pressures on the service were such that I often did not know who I was going to visit in advance, giving little time for any forward planning, let alone working out the logistics of completing the round. Obtaining simple information from nonstandardised assessments on crumpled sheets of paper was challenging and time-consuming.
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Wound Masterclass - Vol 1 - September 2022
I often found it hard to identify the key assessments that had been undertaken, and the resulting actions from them. Equally, deciphering the previous care plans to know what had been tried before, what worked, and equally what did not work was at times impossible. Fundamental questions such as how long the patient had the wound, what it looked like last week, last month and in some cases years before, took a long time to answer. The deployment of Electronic Patient Records (EPR) had the potential to improve this by standardising the recording of wound assessments. In my view, many of the EPRs on the market use a primary care model of recording, where often singular interventions are recorded in free text boxes and templates that lack any form of validation. This results in variation between clinicians in how and where things are recorded. If information is not in a consistent place, clinicians will have to hunt for it, potentially increasing the amount of time it will take them to get the information that they need. The secondary effect is that key data cannot be extracted for analysis of variables, such as healing rates.
Tracking the Wound Wound dimensions are frequently used to determine the progression of a wound. Frequently, for lack of a better available method, paper rulers are used to obtain these measures, even though this can result in the over-estimation of the wound area by 40%.6 To highlight this, the United Kingdom and
Mr Michael Oliver Programme Manager, Livewell Southwest Plymouth, United Kingdom