Technology‐enabled remote management of diabetes foot disease and potential for reduction in associated health costs: a pilot study

Main, F. Beachley; Zubala, Ania; Gorman, Jane; Jones, Sandra C.; Hall, Jenny; Macfarlane, David P.; MacRury, Sandra

doi:10.1186/s13047-020-00444-6

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Primary users in our study reported high rates of satisfaction with the Healthy.io Minuteful for Wound Digital Management System. Patients are generally in favor of remote wound monitoring based on data from prior studies, including studies specific to DFU ( 29 – 31 ). In a scoping review of telemedicine solutions for DFU, four main maps emerged: “A whole human not merely a hole in a human,” “Less of a burden on the family, the community, and the environment,” “Competences and continuity of care are essential for high-quality care” and “The quality and modality of the technology.” Consistent with these concepts, our patients reported less frequent in-person appointments, better continuity of care, and more accountability with care as benefits.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers

Keegan,

Bose,

McDermott

et al. 2023

Front. Endocrinol.

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BackgroundRegular clinical assessment is critical to optimize lower extremity wound healing. However, family and work obligations, socioeconomic, transportation, and time barriers often limit patient follow-up. We assessed the feasibility of a novel, patient-centered, remote wound management system (Healthy.io Minuteful for Wound Digital Management System) for the surveillance of lower extremity wounds.MethodsWe enrolled 25 patients from our outpatient multidisciplinary limb preservation clinic with a diabetic foot ulcer, who had undergone revascularization and podiatric interventions prior to enrollment. Patients and their caregivers were instructed on how to use the digital management system and asked to perform one at-home wound scan per week for a total of 8 weeks using a smartphone application. We collected prospective data on patient engagement, smartphone app useability, and patient satisfaction.ResultsTwenty-five patients (mean age 65.5 ± 13.7 years, 60.0% male, 52.0% Black) were enrolled over 3 months. Mean baseline wound area was 18.0 ± 15.2 cm2, 24.0% of patients were recovering from osteomyelitis, and post-surgical WiFi stage was 1 in 24.0%, 2 in 40.0%, 3 in 28.0%, and 4 in 8.00% of patients. We provided a smartphone to 28.0% of patients who did not have access to one that was compatible with the technology. Wound scans were obtained by patients (40.0%) and caregivers (60.0%). Overall, 179 wound scans were submitted through the app. The mean number of wound scans acquired per patient was 0.72 ± 0.63 per week, for a total mean of 5.80 ± 5.30 scans over the course of 8 weeks. Use of the digital wound management system triggered an early change in wound management for 36.0% of patients. Patient satisfaction was high; 94.0% of patients reported the system was useful.ConclusionThe Healthy.io Minuteful for Wound Digital Management System is a feasible means of remote wound monitoring for use by patients and/or their caregivers.

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Section: Discussionmentioning

confidence: 99%

Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers

Keegan,

Bose,

McDermott

et al. 2023

Front. Endocrinol.

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“…Main et al. ( 31 ) piloted another tablet-based application combining wound photo imaging and remote telemedical video conferencing consultations on the NHSNearMe platform with 31 DFU patients. The authors report an 89% rate of healed, improved, or stable ulcers with improved healing in 49.1% (out of 55 ulcers).…”

Section: Resultsmentioning

confidence: 99%

“…No studies attempt to combine more than three DHTs and thus to combine multiple data sources for diagnosis or personalised intervention. Only four of 81 studies combined objective (from sensors and images) and subjective (via mobile phone apps) data ( 30 , 31 , 35 , 36 ).…”

Section: Conclusion and Next Stepsmentioning

confidence: 99%

Data-driven digital health technologies in the remote clinical care of diabetic foot ulcers: a scoping review

Lazarus,

Cioroianu,

Ehrhardt

et al. 2023

Front. Clin. Diabetes Healthc.

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BackgroundThe availability and effectiveness of Digital Health Technologies (DHTs) to support clinicians, empower patients, and generate economic savings for national healthcare systems are growing rapidly. Of particular promise is the capacity of DHTs to autonomously facilitate remote monitoring and treatment. Diabetic Foot Ulcers (DFUs) are characterised by high rates of infection, amputation, mortality, and healthcare costs. With clinical outcomes contingent on activities that can be readily monitored, DFUs present a promising focus for the application of remote DHTs.ObjectiveThis scoping review has been conducted as a first step toward ascertaining fthe data-related challenges and opportunities for the development of more comprehensive, integrated, and individualised sense/act DHTs. We review the latest developments in the application of DHTs to the remote care of DFUs. We cover the types of DHTs in development and their features, technological readiness, and scope of clinical testing.Eligibility criteriaOnly peer-reviewed original experimental and observational studies, case series and qualitative studies were included in literature searches. All reviews and manuscripts presenting pre-trial prototype technologies were excluded.MethodsAn initial search of three databases (Web of Science, MEDLINE, and Scopus) generated 1,925 English-language papers for screening. 388 papers were assessed as eligible for full-text screening by the review team. 81 manuscripts were found to meet the eligibility criteria.ResultsOnly 19% of studies incorporated multiple DHTs. We categorised 56% of studies as ‘Treatment-Manual’, i.e. studies involving technologies aimed at treatment requiring manual data generation, and 26% as ‘Prevention-Autonomous’, i.e. studies of technologies generating data autonomously through wearable sensors aimed at ulcer prevention through patient behavioural change. Only 10% of studies involved more ambitious ‘Treatment-Autonomous’ interventions. We found that studies generally reported high levels of patient adherence and satisfaction.ConclusionsOur findings point to a major potential role for DHTs in remote personalised medical management of DFUs. However, larger studies are required to assess their impact. Here, we see opportunities for developing much larger, more comprehensive, and integrated monitoring and decision support systems with the potential to address the disease in a more complete context by capturing and integrating data from multiple sources from subjective and objective measurements.

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“…Digital technology is important in supporting health services, including improving nursing care, education, and decision making. [1][2][3][4][5][6] Digitalization provides convenience and has a positive impact on the health sector, 1 which is currently experiencing demand for a fast and precise shift. The coronavirus disease 2019 (COVID-19) pandemic has also encouraged the acceleration of the use of digitalization in health services for reasons of physical restrictions.…”

Section: Introductionmentioning

confidence: 99%

“…The coronavirus disease 2019 (COVID-19) pandemic has also encouraged the acceleration of the use of digitalization in health services for reasons of physical restrictions. 1,7,8 The use of digital technology in this era aims to reduce the speed of transmission of contact transmission of infection. 8,9 Some of the developments in digitalization in the COVID-19 era include telemedicine and telenursing.…”

Section: Introductionmentioning

confidence: 99%

Digital nursing promotion has increased ethics digital literacy: Program improvement

Hariyati,

Handiyani,

Zaharany

et al. 2024

F1000Res

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Introduction Digital technology plays a positive role in helping nursing services work more effectively and efficiently. This study reports on a competency improvement program based on the promotion of digital literacy. Methods This study applies the Assessment, Development and Design Program, Implementing and Evaluation (ADDIE) approach, which consists of five stages. The first is a study of gap assessment needs to increase digital literacy and an analysis using a Fishbone Diagram. The second to fifth stages are development, program design, implementation, and evaluation. The participants consisted of 10 nurses for the initial assessment using Focus Group Discussion. The sample for evaluating digital literacy pre- and post-implementation consisted of 25 nurses selected via purposive sampling. Nurses included in the evaluation stage are those who participated in digital literacy promotion. The instrument used was the “Person-Centered Digital Literacy” questionnaire, the validity of which was in the range of 0.497–0.897, with a reliability value of 0.975. Results In the first stage, the fishbone analysis recommended developing a program promoting digital literacy. Implementation was delivered to nurses after the flow and learning materials were developed and confirmed by nursing experts. The program increased perceptions (20%) of ethical attitude, awareness of data confidentiality and security, and use of social media with wisdom. Conclusion The promotion of digital literacy with ADDIE model is needed to improve the competency of nurses in digital technology.

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Technology‐enabled remote management of diabetes foot disease and potential for reduction in associated health costs: a pilot study

Cited by 5 publications

References 7 publications

Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers

Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers

Data-driven digital health technologies in the remote clinical care of diabetic foot ulcers: a scoping review

Digital nursing promotion has increased ethics digital literacy: Program improvement

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