District trials wound care app in an Australian first

July 2020

RPA tests ground-breaking app to better manage patient wounds

Sydney Local Health District is piloting an app that uses artificial intelligence (AI) to measure, analyse and treat patient wounds – with RPA the first hospital in Australia to test the revolutionary technology.

The Tissue Analytics digital app provides clinicians with real-time data to help determine the best treatment options for patients, the type of wound dressings to apply and monitors the progress of wound healing.

"This is the first trial to examine the use of AI in the management of wound care in Australia. It's a game-changer," Dr Michelle Barakat-Johnson, the District's Skin Integrity Lead, said.

"It has the potential to transform the way clinicians across the country provide care for patients who have acute or chronic, complex wounds," Dr Barakat-Johnson said.

It's hoped the use of the app will result in patient wounds healing faster – cutting the length of hospital stays and reducing the likelihood of re-admission for wound care within 30-days.

The District was awarded an $81 000 innovation grant from eHealth NSW to trial the app at Royal Prince Alfred Hospital and Sydney District Nursing.

It's being trialled in the Aged Care and Colorectal wards, the outpatient Dermatology Clinic, and in Sydney District Nursing which delivers in-home nursing care in the community, and at rpavirtual, which provides 24/7 virtual patient care.

During the eight-month pilot, clinicians are using the app on a smartphone to take photos of a patient's wound which are automatically stored in a secure cloud and then transferred to the patient's electronic medical record (eMR).

The app uses top tier image recognition technology to accurately measure the wound's dimensions, perimeters, and surface area and analyses the tissue composition of the wound.

An algorithm, based on world's best practice guidelines, and other clinical decision-making tools, provides clinicians with advice about wound care.

So far, close to 60 patients are participating in the trial, with doctors and nurses using the app to analyse more than 84 different wounds.

The common types of wounds assessed include pressure injuries, leg and foot ulcers, post-operation wounds, and skin tears or blisters.

RPA patient Jeff Dean said the use of the app had a positive impact on him, and his family, as he slowly recovers from a stomach operation.

"When I first saw the size of the wound, I thought 'How is this going to heal?'

"So, it really made a big difference to be shown the photos every few days and to be able to see improvements in the healing of the wound. It was reassuring. It helped the whole family. I knew I was going to get out of hospital sooner, rather than later," he said.

Another RPA patient Lorraine Grimson agrees.

"It's reassuring each time they come along and take a photo and you can see that you're actually progressing forward healthily… being able to see that makes me feel positive about the healing," she said.

The app has other benefits too.

"It will improve the quality of wound documentation in the eMR. It will bring the documentation in line with current best wound care practices," Aaron Jones, the District's Chief Nursing and Midwifery Information Officer, said.

"It aims to result in better monitoring, tracking and reporting of patient wound outcomes in the eMR. And, it also may benefit clinicians by reducing the amount of time spent on wound documentation," he said.

In some cases, outpatients who care for their own wound, or have a carer who manages their wound, are able to use a version of the app to help document their own care.

When an outpatient uploads an image to the app, their treating clinician is automatically alerted and follow-up or referrals are put in place as required.

The Tissue Analytics pilot is the result of a NSW working group, chaired by the District and involving 14 Local Health Districts, set up to address issues identified with wound documentation in the eMR.

If the trial's a success, the app will be tested in primary health care, such as a GP practice, and in a rural health district in New South Wales ahead of plans for a state wide rollout.