App lets clinicians monitor patients’ postoperative wounds

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A new smartphone app enables patients to send images of their surgical wounds from home to allow clinicians to monitor them for infections, which are a leading cause of hospital readmission after an operation.

The iOS app, called WoundCare, is HIPAA compliant and was developed by the Wisconsin Institute of Surgical Outcomes Research in the Department of Surgery at the University of Wisconsin-Madison.

Researchers created an image-based mobile health protocol designed to help detect postoperative surgical site infections earlier in patients recuperating at home, seeking to avoid wound complications that require hospital readmissions.

“We set out to come up with a protocol where patients could become active participants in their care and allow us to be in closer communication and monitor their wounds after they leave the hospital,” says Rebecca Gunter, MD, lead author and general surgery resident at the University of Wisconsin. “This approach allows us to intervene at an earlier time rather than waiting for patients to come back in after the problem has already developed past the point of being able to manage it on an outpatient basis.”

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In a study funded by the Agency for Healthcare Research and Quality, 40 vascular surgery patients were trained on how to upload images of their surgical wounds through the app and to answer questions in a brief survey used to gather additional information about their recovery.

Each patient enrolled in the study was provided with an Apple iPhone 5S as well as a visual reference guide to assist them in using the smartphone and app daily for two weeks. Overall, there was a data submission rate of 90.2 percent among participants, and submissions were reviewed within an average of 9.7 hours, which resulted in seven wound complications being detected with only one false negative.

“We have demonstrated that a population of complex and high-risk patients, many of whom are older adults and novice smartphone users, can complete this protocol with high fidelity and satisfaction,” conclude the study’s authors.

While the nurses in the study who were responsible for reviewing the submitted images saw the value of the mobile health program, they reported that it was difficult to juggle the demands of remote wound monitoring in addition to their clinical workload. As a result, researchers contend that having a dedicated transitional care program—and not just adding tasks to already heavy staff workloads—is critical to ensuring the success and sustainability of such a protocol.

Although cost-savings were not measured as part of the study’s scope, Gunter says future studies will examine the financial impact.

“If you could imagine saving the cost from the number of patients whose readmission you were able to prevent, that result could provide significant savings to the health system,” adds Gunter, who along with her co-authors note that surgical site infections cost an average of almost $30,000 per wound-related readmission and an estimated $3 billion to $10 billion nationwide every year.

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