1. Telewound Management: A Model for Value-Based Care
South Carolina Telehealth Summit
2017 Annual Conference
Copyright © 2017 Corstrata

2. The Wound Problem
Copyright © 2017 Corstrata

3. 1:500 6.5M $33B The US Wound Problem Not Enough Experts to Meet Need
wound nurse
patients
annual cost
Not Enough Experts to
Meet Need
Millions of Patients
in Need
Massive Cost to
Providers
Copyright © 2017 Corstrata

4. The Problem – High Costs
Wound Supplies
Dressings
Advanced therapy modalities
Negative Pressure Wound Therapy
E-Stimulation
Enzymatic debridement
Labor
Dressing change frequency
Number of wounds
Associated wound documentation time
Copyright © 2017 Corstrata

5. The Problem – Quality Wound/Ostomy Related Hospitalizations
29.1% – ileostomy & enterostomy – 30-day readmission rate
23% – amputation of lower extremity
19% – colostomy 30-day readmission rate
7.8% – surgical wound issues
Quality Outcomes
Wound-related outcome measures
Acute Care – acquired pressure ulcer penalties
Post-Acute Care – number of pressure ulcers that are new or worsened
Wounds impact on quality of patient satisfaction
Copyright © 2017 Corstrata

6. The Problem - Liability
Legal Liability Exposure
There are 17,000 pressure ulcer related lawsuits filed annually
Number of wound related lawsuits are increasing in the home health space
Recent pressure ulcer lawsuits in acute & long-term had judgments as high as $312M
Families take photos
Copyright © 2017 Corstrata

7. The Problem – Wound Care Barriers
Wound care practice relies on:
Personal experience with wound treatment
Opinion of colleague(s)
Lack of knowledge & education:
Basic wound evaluation/assessment
Wound treatments & management practices
Wound prevention protocols
Use of advanced supplies and treatment modalities
Lack of standardization:
Wound measurements
Wound outcomes/metrics
Wound quality reporting
Copyright © 2017 Corstrata

8. Telewound Model
Copyright © 2017 Corstrata

9. Telewound Model – Literature Review
Literature review indicates telewound care:
Improves wound outcomes
Increases healing time rate
Increases % of wounds healed
Decreases amputations
Reduces number of hospitalizations
Increases access to care
Increases effective use of scarce wound experts
Provides access to wound experts in underserved & rural areas
Reduces costs
Reduces treatment costs
Reduces transportation costs
Reduces wound consultation costs
Copyright © 2017 Corstrata

10. Wound Imaging Technology
Wound Imaging Software:
Auto measurements
Increase accuracy of wound measurements
Color correction
Overlay
Documentation
Reduces in-home staff wound documentation time
Facilitates benchmarking healing/ closure rates
HIPAA Compliant
Conventional
44% Measurement Error
~60 seconds to measure
New Technology
< 5% Measurement Error
~25 seconds to take photo & auto-measure
Copyright © 2017 Corstrata

11. Video Technology Utilize Video Conferencing HIPAA Compliant
Use for Access to:
Wound Expertise
Physician Consult
Use for:
Triaging Ostomies
Triaging NPWT
Proper Application of Wound Dressings
Copyright © 2017 Corstrata

12. Telewound Process Identify wound etiology
Etiology drives treatment
Recommend evidence based treatments
Treatment protocol drives:
Dressing type
Frequency of dressing changes
Advanced treatment modalities
Monitor wound progression
Telehealth ‘wound rounds’ with provider clinicians
Recommend treatment changes as indicated
Copyright © 2017 Corstrata

13. Telewound Consults: Tele-Wound Consultations Consultation includes:
Identification of wound etiology
Treatment recommendations
Formulary recommendations
Triage support:
Negative pressure therapy
Ostomy appliances
Pain and symptom management
Copyright © 2017 Corstrata

14. Outsourced Telewound Delivery Model
Copyright © 2017 Corstrata

15. Telewound Results
Copyright © 2017 Corstrata

16. Ancillary Benefits Nurse workforce: Telewound job benefits:
Avg. RN Age = 50
% working RNs > age 50 = 53%
Telewound job benefits:
Eliminates physicality of nursing
Allows for continued passion to improve care and educate provider staff
*The National Council of State Boards of Nursing and The Forum of State Nursing Workforce Centers, 2013 National Workforce Survey of RNs
Copyright © 2017 Corstrata

17. Telewound Results – Nursing Homes
Quality:
Improved wound quality outcomes
Improved patient quality of life
Reduced days to healing
Decreased number of facility/provider acquired pressure ulcers
Regulatory/Risk Management:
Increased accuracy of wound documentation
Decreased litigation exposure
Decrease denials related to medical necessity
Financial:
Access to CWOCN without investment in FTE −net savings $100K/year)
Reduced frequency of daily dressing changes
Nursing time savings − $400/week for a 100 bed facility
Decreased wound supply costs (average savings 30%)
Copyright © 2017 Corstrata

18. Telewound Results – Home Health
Quality:
Reduction in ostomy- related readmissions from 30% to 10%
Reduction in wound- related readmissions
Reduction in provider acquired pressure ulcers
Improved clinical outcomes & patient quality of life
Enhanced patient/family satisfaction & loyalty
Regulatory:
Improved wound care documentation for compliance audits
Financial:
Access to CWOCN without investment in FTE − net savings $100K/year)
Reduction in number of in- home nursing visits - RN time plus mileage
Decrease frequency of dressing changes (one visit per week savings of $750 on a $3,000 episode)
Decrease wound supply costs (average savings 30%)
Increased accuracy in wound related coding
Copyright © 2017 Corstrata

19. Telewound Success Story
At admission to Telewound Program
After 10 weeks of Telewound Consults
At the time of admission to Telewound program, patient had wound for over 22 months.
Copyright © 2017 Corstrata

20. On the Horizon Payers: Value-based delivery models: Consumers:
Medicare Advantage
Medicaid HMOs
Commercial Insurers
Self-insured Employers
Value-based delivery models:
Accountable Care Organizations
Bundled Payment Projects
Consumers:
Ostomates
Copyright © 2017 Corstrata

21. Katherine Piette CEO & Founder Corstrata
(912)
Copyright © 2017 Corstrata