Shaping Wound Care’s Future Begins with Strong Partnerships

By John Gresham, President, Wound Care Division Net Health

These days, healthcare organizations – from large health systems to rural hospitals and payers to vendors – are trying to achieve a basic goal: survive in a rapidly evolving environment.

Industry leaders discuss multiple solutions and strategies in board rooms, executive offices, conferences, and events. Do we just need the latest technology solution? A high-priced consulting firm? An acquisition or merger? What magic bullet will enable our organization to survive and thrive in the future?

I’ve found another solution that works for any organization—no matter the size, location, or status. My approach is to seek out more meaningful collaboration with the people, businesses, and groups you partner with to adopt or provide goods, technologies, or services. I know we’re used to hearing “partnering for success” as nothing more than lip service. I’m talking about taking that concept to the next level—living and breathing the ideals.  

Valued partnerships should focus on the following for success:

• Understanding one another’s business models and needs
• Recognizing operational capabilities and challenges
• Focusing on optimizing clinical outcomes and productivity
• Improving and integrating technologies
• Emphasizing the importance of people and communities and access to care

Look for people—notice I didn’t say vendor, corporation, or business—who share your ideals and are committed to helping you achieve your goals and vice versa. Focus on building lasting partnerships that help your organization reach and exceed those goals.

I recently attended the Net Health NEXT Customer Conference in Tampa, Florida. It was our first-ever event dedicated solely to our customers, to celebrate their successes, listen to their challenges, and create dialogue around a shared vision for the future. As the new President of Net Health’s Wound Care division, I was inspired by the stories of partnership and collaboration. In one case a large health system turned to us for help when they identified a major source of reimbursement denials. Together, we used the functions of our EHR to find a solution. There was also a private practice clinic that worked with us to leverage data from the Wound Care EHR and better understand their market. The result was a precise strategy and activation that has helped them grow, with best-in-class hospitalization and healing rates.

I also learned about how Net Health teams impact the day-to-day of our customers, through open dialogue, problem-solving and simple listening. We can do more through education opportunities to provide more insights and expanded service capabilities to help our partner’s keep pace. That’s what I consider to be the essence of partnership — to connect with one another, collaborate openly, address challenges — and then celebrate success. I saw it play out consistently during the Net Health NEXT conference, whether in our Customer Advisory Boards, Product Advisory Councils, or our live panel session.

So where do you start?

Understanding Business Models and Needs

It’s difficult to provide effective goods, services, or insights without first fully understanding an organization’s current business model, future plans, and overall ecosystem. For wound care providers in vertically integrated health systems, public or private hospitals, outpatient clinics or independent practices, that means understanding the implications of the quickly evolving value-based care (VBC) and fee-for-service.

A true partner will work with an organization to identify the solutions that will most impact core business areas, like reimbursement. For example, software that provides accurate documentation of the steps taken during a patient’s wound care encounters, plus the required reporting, enable an organization to avoid penalties, identify missed revenue streams, and prevent delayed payments.  

Solutions that focus on business priorities, such as efficient patient scheduling and appointment reminders, can also benefit staffing, patient flow, and the number of patients that can be seen, helping to optimize revenue and patient experience.

This kind of partner will take their service further by providing counsel, guidance, and insights.  For example, they will provide the support needed for a hospital or private practice struggling to shift to value-based care models, bringing in their industry experts and experience to guide best practices and real-world steps to make a timely transition. They’ll also work closely with you to help identify risks by using existing data and industry benchmarks, highlighting areas that may increase exposure to penalties, fines, or reduced reimbursement. 

Most importantly, a true partner will support you in today’s economic environment, where fee-for-service is still the reality but value-based payment models are the future. They won’t wait for you to ask them questions; they will come to you with ways to win and help you on the pathway to success.

Recognize Operational Capabilities and Challenges

One of the many challenges facing wound care programs today is the need to care for more patients with fewer resources, from  staffing to revenue and more.  That’s a tough hill to climb. 

Innovative technologies and intelligent business planning can help. As someone relatively new to Net Health, I’ve been impressed with the real-world solutions our team of experts bring to clients.  Many of our customers have voiced concerns over CMS’s efforts to claw back billions of dollars they view as overpayments to hospitals and insurers. For the 2023 fiscal year, the Medicare Fee-for-Service (FFS) report estimated that the improper payment rate was $31.2 billion. Some wound care providers have already been caught up in the initiative and hit with significant fines; others fear they’ll be next. 

Building on our existing CORE strategy, which provides a step-by-step plan for streamlining Clinical, Operational, Regulatory, and Economic efficiencies, we created a new playbook for our customers called ThinkFlow. It maps the guidelines and policies governing prevalent wound care procedures and therapies and aligns them with the documentation processes CMS and the OIG look for in audits. 

Our how-to-guide provides clients with clear steps to ensure accurate documentation, adherence to regulations, streamlined workflow, and more. ThinkFlow also depicts the intentional actions within a workflow that pull documentation and payment together. Together, our proprietary CORE and ThinkFlow programs provide a powerful playbook to help organizations avoid or navigate through audits and adapt to emerging payment models.

Coding proves to be another challenge for providers. With an increasing number of advanced wound care procedures and a rash of new therapies, compliant and correct coding, and the resulting billing it can generate, it is crucial.  Partners that focus on providing software with that coding embedded in their electronic health records (EHRs) and continuously monitor for updates and changes save providers time and money.

Optimizing Clinical Outcomes

One of the most important benefits strong wound care partners can offer is insights and guidance for improving clinical outcomes—which helps patients as well as providers. The best way to achieve that objective is to supply the tools, data, and relevant information to wound care providers who need to make optimal care decisions.

We look at that topic daily and push ourselves to answer the questions that matter to you.

• What are we doing to move into more prescriptive intelligence around the recommendations based on the image? 
• How do we make sure it fits in their workflow seamlessly?  
• Does it fit documentation workflow? 
• How can we make our caregivers more productive?

Consider the following scenario: Guidelines say a 75-year-old patient in the hospital for heart failure with multiple comorbidities and a pre-existing pressure injury should heal within six weeks. Considering their overall health status, wound care professionals know it’s much more likely to take double that time. 

Situations like this – where the complexity of a patient’s status isn’t factored into the metrics – present a difficult challenge. However, when documentation and data supports the treatment provided, payers will often adjust, or at the least accept, the care plan provided. We often work with our clients and industry associations to reach out to payers, and even representatives within CMS and other governing bodies, to build a case for better and more accurate guidelines and best practices.

Accurate wound care measurement is also critical to optimal outcomes. It’s not innovative; it’s required, and will be more so with the continued evolution of alternative payment models and policy adjustments. Accurate and reliable wound measurement tools are essential for optimizing patient care and outcomes, as they enable physicians to measure, monitor, and develop effective treatment strategies, ensuring evidence-based best practices in wound care. 

Despite its importance, wound care measurement is tremendously variable, even within the same organization and often by the same provider. Look for partners with the technology and track record to help you consistently and accurately automate wound measurement.  Such technology should be able to reduce measurement errors to under 5%.

Improving and Integrating Technologies

All the elements we’ve discussed so far have one thing in common: advanced specialized wound care technologies. Whether documentation, wound measurement, reporting, or some other feature, wound care technology is crucial in ensuring that providers complete necessary tasks and that care is provided accurately and efficiently. Currently, a range of technologies are available for wound care programs, from EHRs to advanced digital imaging platforms to artificial intelligence (AI) and predictive analytics to identify at-risk wounds.

Selecting the ideal technology application for an organization is a complex task that wound care providers and leadership must take seriously.  A trusted partner can help an organization make the best decision. But it’s a delicate balance. Vendors, of course, want to sell their products and services. However, a true technology partner will help a customer make the best selection in the long run, even if it doesn’t involve one of their products in the short term. If it does, the partner will help their client identify strategic and cost-effective ways to integrate technology seamlessly into their current program.

I can’t stress enough how vital today’s advanced wound care technologies are to building successful wound care programs. The right wound care technology can bring in a lot of value.

Using advanced digital wound care platforms, a large hospital system in the mid-Atlantic reduced hospital-acquired pressure injuries – a core component for VBC programs – by 83% and reduced costs from $3.6M to $700k in just six months.

Using the same technology, a major hospital system in the Southeast achieved:

• A 20-day improvement in days to heal through continuous evaluation of cases, adherence to standards of care, and identifying areas for improvement. 
• Reduced time on administrative tasks for nurses by one to two hours per provider.
• A remarkable 95% reduction in denial rates within the first two years.
• A 33% increase in the number of patients the program could see – an average of six to eight patients daily, also growing revenue.

Successes like these, achieved through collaboration with a trusted partner, highlight that technology is crucial to combat wound care programs’ key challenges, whether workflow, compliance, or reimbursement. Look for partners who will work with you on customizing solutions, too. It should never be one-size-fits-all in healthcare. The ability to tailor solutions for an organization’s unique situation is essential.

Emphasizing the Importance of People and Communities

One of the biggest trends in healthcare over the past decade has been the move toward consumerization. Its goal is to focus our healthcare and service delivery around the needs, preferences, and values of the patient, and yes, to treat them as customers, which they are.

Healthcare consumerization is revolutionizing how patients and healthcare providers manage and treat wounds. In today’s digital age, technology has become a powerful tool for empowering patients and engaging them in their own healthcare journey. Mobile apps, telemedicine platforms, and wearable devices are just a few examples of digital solutions that can enhance patient engagement. 

These digital solutions align with value-based care goals by emphasizing engagement, outcomes, and efficiency. Plus, by integrating advanced technologies into wound care, hospitals and healthcare providers can achieve higher patient satisfaction rates, reduce hospital readmissions, and lower healthcare costs. 

There will be some problems to solve along the way.  It will be tricky to help patients live their healthiest lives while balancing between clinical and personal wound management. There may be times when the two clash or when, because of social determinants of health (SDOH) or other issues, we find it difficult to achieve our goals. We should still strive for the ideal.

We also need to think beyond our own four walls to find out what’s required in the communities we serve. We need to find a better way to help the unhoused with untreated wounds find care in urban areas. In rural areas, many of which are losing hospitals at alarming rates, we must embrace mobile wound care clinics and increase use of tele-wound care visits.

It’s going to start with asking ourselves some pointed questions, including:

• How are we moving toward this future? 
• What do patients want? What will most benefit the communities we serve?
• How can we optimize technologies so that all patients – even older, less-tech-savvy-ones — can benefit? What are the challenges we face today and the opportunities tomorrow?  

Through collaboration, we can start answering these questions.

Partner Up to Succeed in the Future of Wound Care

As we continue to see technological advancements, the potential for innovative wound care solutions that benefit patients and providers is vast, promising a future where everyone involved in the healing process is empowered and engaged.

However, none of us will achieve that promising future of wound care if we don’t communicate, collaborate, and find ways to partner for our success and the health and well-being of our organizations and patients.