Dr. Ron Silverman discusses the presentation titled “A patient centered remote therapy monitoring program focusing on increased adherence to wound therapy: a large cohort study,”, which focuses on remote therapy monitoring (RTM) with iOn PROGRESS™ Remote Therapy Monitoring. This study was presented at the 2018 Symposium of Advanced Wound Care (SAWC) Spring Conference.
Ron Silverman, M.D., F.A.C.S., is a widely recognized clinical expert in cosmetic and reconstructive surgery, complex wound management, abdominal wall reconstruction and tissue engineering for reconstructive surgery. Before joining KCI as Senior Vice President and Chief Medical Officer, Dr. Silverman served as Chief of Plastic Surgery at the University of Maryland School of Medicine and continues to teach as an Associate Professor there. Previously, he held academic positions at John Hopkins School of Medicine, Harvard School of Medicine and served as Chief of Plastic Surgery at the Baltimore Veterans Administration Medical Center. Dr. Silverman completed his residency at Harvard/Massachusetts General Hospital in Plastic Surgery, and earned his medical degree at the University of Maryland School of Medicine. He is certified by the American Board of Plastic Surgery and is a member of several professional organizations, including the American College of Surgeons, the American Society of Plastic Surgeons, the Plastic Surgery Research Council, the American Cleft Palate and Craniofacial Society and the American Association of Plastic Surgeons.
-TRANSCRIPT OF INTERVIEW-
Neal Howard: Welcome to Health Professional Radio. I’m your host, Neal Howard. Thank you so much for joining us today today. Today, I am in studio with Dr. Ron Silverman. He’s joining us here from KCI as Senior Vice President and chief medical officer and he’s going to talk with us today about a presentation at the 2018 Symposium on Advanced Wound Care. Thank you for joining us today, Dr. Silverman.
Dr. Ron Silverman: Thank you very much for having us.
N: Right. There was an oral presentation as I said at this 2018 Symposium on Advanced Wound Care. Talk about this presentation and what does it mean for this brand-new therapy that we’re going to discuss?
R: Okay. Well, thank you. So this presentation was about a program that we have called iOn PROGRESS™ Remote Therapy Monitoring. This works in conjunction with our ACTIV.AC™ Therapy. ACTIV.AC™ Therapy is the therapy that provides V.A.C. Therapy which is a type of wound care for patients with wounds in the home. It is the first negative pressure wound therapy system. KCI is the first company to bring negative pressure wound therapy over 25 years ago in the United States and we continue to innovate on this each passing year. Our newest innovation again the iOn PROGRESS™ Remote Therapy Monitoring, this allows us to monitor whether or not a patient is actually adhering to the therapy that has been prescribed to them at home. It’s the first system to deliver this sort of continuous at home monitoring for negative pressure wound care and it leverages digital connectivity in order to monitor this adherence. This data is transmitted securely to the KCI iOn PROGRESS care network team which is a group of highly skilled and trained nurses and have the opportunity to interact with the patients directly as well as the caregivers to encourage compliance with our therapy. So the device, it’s a medical device that’s placed on a wound is placed by a physician or nurse and then the patient is sent home and at least twice a week someone visits their home in order to change the dressings. But it is a machine that includes computer software and hardware that provides negative pressure wound therapy essentially suctioning on the wound to stimulate the wound to get smaller much faster than other techniques. There have been many studies that documents increase rates of wound healing, the ability to fill in a wound and have the wound essentially get much smaller, much faster on a variety of types of wounds. One of the things that we’ve learned over the years though, is that if a patient is not adherent to the therapy, in other words that they turn off the machine or for whatever reason maybe there’s an alarm and the machine gets turned off, then obviously the patient does not get the benefit of the therapy.
N: What’s the patient learning curve for using the software and the device?
R: So the patient really doesn’t have to do anything. Essentially there’s a nurse that comes to their home a couple times a day but if there is an alarm that goes off, ideally the patient would then call the caregiver to decide what to do but what we have found is that in many instances, patients were simply turning off the machine. So the idea of this study was to say, “Hey. If we can remotely determine that there’s something going on either the machine’s turning off or there’s alarm and we can proactively reach out to the patient call them then we can actually dramatically increase the adherence to the therapy and when we say adherence to the therapy we simply mean that the patient continues to get the therapy. In other words, they don’t turn it off or shut it off or it turns off itself or something like that.
N: That’s why I was asking about how much the patient understands how this device works and the importance of adherence and making those calls and contacts when that is appropriate.
R: Well, we think that we can always do better with efficient education and that’s one of the nice things about this program. As soon as the patient is sent home with our therapy, they get a call from our group of nurses in the iOn PROGRESS care network. They introduce themselves and have another opportunity beyond whether it was in the wound care center of the hospital beyond whoever explained it to them, initially, we have someone who’s truly an expert that can go through everything yet again with them. So that’s a beautiful benefit of this program. But the main finding of the study was that the vast majority of patients when they got a second call, in other words, when we were alerted remotely through our remote therapy monitoring that something was amiss, something was going wrong maybe the machine was alarming or it was simply just turned off, if we call the patient the vast majority of them, 73.5% demonstrated an increase in compliance or adherence with the therapy on the following day which is that is a very high response.
N: Were there any other positive results other than obvious patient adherence at such a high percentage rate?
R: Yes. I think the idea or the concept is that in addition to just getting adherence you would hope that that translate into some clinical benefit to the patient and one of the things that we noticed in this group of patients, and again it was over 500 patients studied, that when we looked at the patients that increased their percentage of time that the machine was being utilized so going from less than 60% to those using it over 90% of the time, they had a 50% increase in their rate of volume reduction of their wound. So in the percent change in the volume of the space of the wound would demonstrate a significant reduction in the rate that it was getting smaller.
N: Now, in wrapping up doctor, first of all, what in your opinion do you see as the future of our TM based on these very positive results and tell our listeners where we can go online and learn more?
R: Okay. Well, so first of all, the benefits of this are not only in clinical outcomes for the patient but also in the tremendous economic burden that our healthcare system faces due to chronic wounds. I mean we know that there are over 6.5 million patients in the United States alone affected by chronic wounds, the cost is extremely high about 24% of all Medicare readmissions are wound-related and obviously making a dent in that is good, not only for each individual patient but for the payers as well as the entire nation in our budget.
N: Could you give our listeners a website where we can go and learn more?
R: Absolutely. Just simply go to acelity.com and you will learn about the eOn PROGRESS™ Remote Therapy Monitoring program.
N: Well, I thank you for coming in today.
R: Very good. Thank you very much.
N: All right. You’ve been listening to Health Professional Radio. I’m your host, Neal Howard in studio with Dr. Ron Silverman. Transcripts and audio of this program are available at hpr.fm and healthprofessionalradio.com.au.