Research in wound management
There is great potential in streamlining health care with innovative digital solutions and this applies not least in hard-to-heal wounds.
Thanks to various research projects, together with several different care providers connected to RiksSår, the Swedish National Quality Registry for Ulcer Treatment, we have been able to develop and evaluate Dermicus as a digital workflow and collaboration platform for hard-to-heal ulcers (formerly referred to as a Digital Decision Support System) – Dermicus Telewound.
Figure: Significantly lower antibiotic prescription, 8% vs 26%. DDSS compared to RUT (Registry for Ulcer Treatment). Wickström HL et al. Antibiotic prescription using a digital decision support system: a register-based study of patients with hard-to-heal ulcers in Sweden, BMJ Open, 2022 Oct 27;12(10).
The platform can today be used by healthcare providers and facilitates diagnosis and correct treatment of patients with hard-to-heal ulcers. The solution consists of a mobile app and a web application for remote multidisciplinary collaboration, clinical monitoring and structured training of healthcare staff.
Ongoing research and development projects
We have worked with the leading organisations and key opinions leaders in wound management in Sweden. We can translate the reported findings and discuss these experiences with you, as you consider the planning of your study. Please contact us here.
Experiences of the Swedish National Quality Registry – RiksSår
RiksSår presented the evaluation of Dermicus Telewound at the international wound care conference EWMA – European Wound Management Association) in Gothenburg on 7th June 2019. The presentation can be found here as a first report on how Dermicus Wound delivered the transfer of data to RiksSår works in everyday clinical practice.
On 7 October 2020, a webinar was also held by EWMA where Dr Rut Öien explained how wound consultations can take place via the Dermicus platform, with the simultaneous entry of data to the national quality register. This approach makes it possible to both follow the individual patient’s wound healing process and gain access to nationally aggregated data about this patient group “Organisation of telemedicine in wound management – Care pathways & teams“. The lecture can be viewed here.
Dermicus Telewound – a tool for the transition to good and close care
The transition to good and close care is about working methods where different actors collaborate more for the benefit of the individual, and where care becomes more accessible in the form of, among other things, digital care services. Some of the success factors for close care are, for example, working in collaboration, integrating mobile solutions in the care chain, research, development and education that support the transition, and digitalisation based on the needs of residents and employees. Source: Anna Nergårdh’s report for the inquiry Good and close care (please contact Gnosco for a translation of this report) See also this report, National Action Plan For Increased Patient Safety In Swedish Health Care 2020-2024, National Board Of Health And Welfare.
Success factors for digital communication and knowledge support are digital wound consultations that can be linked to a national quality register, such as Dermicus Telewound. This means greater efficiency and potential for improvement in primary care. Several new initiatives regarding the implementation of Dermicus Telewound in various clinical environments are underway, including for hard-to-heal leg and foot ulcers, diabetic foot ulcers, pressure ulcers and malignant tumour wounds.
In April 2021, a national publication by SKR, The Swedish Association of Local Authorities and Regions (SALAR) was published that described the project with Dermicus Telewound and the collaboration with RiksSår, the Swedish National Quality Registry for Ulcer Treatment, as a learning and inspiring example of how to work with digital consultations within good and closer care, see (in Swedish) chapter 9: ”Nära vård i hemmet för äldre – inspiration för dig som arbetar inom vård och omsorg”, Lisbeth Löpare Johansson, Samordnare Nära vård, Avdelningen för vård och omsorg, 2021-03-02, ISBN: 978-91-7585-918-7, SKR.
RiksSår, the Swedish National Quality Registry for Ulcer Treatment, including hard-to-heal leg and foot ulcers and pressure wounds was initiated in Blekinge and has been a national quality register for hard-to-heal wounds since 2009. RiksSår has laid the foundation and shown how a structured wound treatment with a focus on diagnosis, targeted treatments and follow-up has improved care for patients with wounds.
RiksSår has actively participated in the validation of Dermicus Telewound over the years and the platform has been tested by care providers connected to the quality register in a large number of places in the country.
RiksSår’s steering group is a national network of clinically active researchers from Skåne University Hospital Malmö, Örebro University Hospital, Skaraborg Hospital, Karolinska University Hospital and Sahlgrenska University Hospital.
The researchers are affiliated with Lund University, Karolinska Institutet, Örebro University, Linnaeus University and Blekinge Institute of Technology.
Examples of international collaborations are:
- Monash University, Melbourne, Australia. Reference: Öien RF, Weller CD. The Swedish national quality Registry of Ulcer Treatment (RUT): How can “RUT” inform outcome measurement for people diagnosed with venous leg ulcers in Australia? Wound Practice & Research 2014; 22 (2): 74-77
- EWMA (European Wound Management Association), www.ewma.org
- Department of Nursing, Brno, Czech Republic and the Czech Ministry of Health. Reference: Pokorna A, Öien RF, Forssell H, Lindholm C. International cooperation for prevention and healing of pressure ulcers is challenged by the lack of national registries. Cesk Slov Neurol N 2016; 79/112 (Suppl 1): 20-24.