On February 5, 2012, the Minneapolis StarTribune featured an article about Advanced Healing Institute’s TRUHEAL Wound Program and its healing outcomes.

Found at the following link:  http://www.startribune.com/business/138687734.html the article summarizes the struggles that new organizations and business models face when they provide disruptive ideas and technologies into a field of medical practices.

Advanced Healing Institute’s TRUHEAL Wound Program provides an outcomes-based healing model to wound care – substituting a round robin of treatment regimens for a evidence-based practice model of documented healing.

As indicated in the article, Advanced Healing Institutes partnership with Fairview Health System to drive wound healing outcomes in Minnesota’s Twin Cities has started to gain traction for a greater and greater number of patients.

Background:  Per the previous blog entry, the patient in question for this entry is the same 81 year old male who has quadriplegia, and undetermined cognitive status.  Patient is bedridden, unable to communicate, and has been so for many years.  The wound in question is a chronic (30 months duration) stage II pressure ulcer on the patient’s coccyx area – approximately 2cm by 2cm in size.  Upon first being introduced to the patient’s wound, the area surrounding the wound was reddened and the skin was macerated.  Caregivers reported that their expectation was the wound would remain indefinitely.

Wound outcome:  After implementation of the TRUHEAL Wound Program including standard treatment tools, guidelines and protocols this wound (which had been present for 30 months of standard care) healed completely in eight weeks on the TRUHEAL Wound Program.

For the purposes of performing the analyses in this portion of the discussion, Advanced Healing Institute partnered with the individual’s Managed Care provider to analyze claims and payments occurring over the 30 month period for which the individual had his open wounds.

After analyzing the host and myriad of claims and procedures during this period, findings indicated the following groupings of care attributable or partially attributable to the wound in question.

Cost categories attributable to this wound include the following:  outpatient procedures such as debridement, durable medical equipment such as a powered pressure reducing air mattress, dressings and incontinence products, antibiotics and antifungals, nursing services, office visits, hospitalizations and transportation.

Across all of those categories, the total amount paid for this individual’s care was in excess of $400,000 during the period.  Based on the estimates of his caregivers and managed care payer the portion of costs attributable to his wound during that period was between $31,000 and $52,000 with a most likely cost of $43,000 attributable to his wounds.

Expected savings:  Based on the figures provided above, Advanced Healing Institute in conjunction with this individual’s Medicare Managed Care provider estimate as system’s savings in excess of $39,000 by adopting the TRUHEAL wound program in this case.

But most importantly, after 30 months of treatment, the patient’s wounds healed after only eight weeks when TRUHEAL Wound Program’s best-practice guidelines were adopted and implemented.

The patient in question for this entry is an 81 year old male who has quadriplegia, and undetermined cognitive status.  Patient is bedridden, unable to communicate, and has been so for many years.

The wound in question is a stage II pressure ulcer on the patient’s coccyx area – approximately 2cm by 2cm in size which had been present for 30 months prior to introduction of TRUHEAL Wound Program.  Upon first being introduced to the patient’s wound, the area surrounding the wound was reddened and the skin was macerated.  Caregivers reported that their expectation was the wound would remain indefinitely.  Considering the condition of the periwound area, the condition of the patient, and the duration of the wound, caregivers had no expectation that the wound would ever heal.

In spite of the fact that none of the aforementioned underlying factors changed during the course of treatment, by applying the TRUHEAL Wound Program caregivers were able to heal the wound in slightly less than two months.  In other words, this individual who in addition to all of his other medical conditions had been forced to undergo regular and periodic exposure and dressing changes to his coccyx area for the prior 30 months was healed in just eight weeks using the new treatment protocols.

In the subsequent entry, we’ll talk about the technical components of what the treatments had been, and the cost of those treatments to the medical system over the 30 month period, but before we do that, we should pause to think about the human factor.  This individual, who is 100% dependent upon his caregivers for his quality of life, had lived with the wound on his coccyx for two and a half years.

Caregivers had written off the wound’s ability to heal.  They’d written off that the patient’s body had the ability to repair itself in that location due to the complicating factors of his condition.  But by accessing and incorporating a new set of protocols and tools, at least that portion of his healing could progress.  Although there are still numerous and very complicated components of care required in this individual’s daily care plan, dressing changes and wound care is no longer one of them.

For several years, our clients, suppliers, business partners and friends have asked us questions like, “why isn’t the TruHeal Program more broadly adopted?  Why haven’t you written more about your successes?  Where can potential clients or partners go to learn more about the experiences you’ve had in creating a healing program and bringing it to the health care system?  And what’s happened as that program has begun to be introduced within the U.S. Health Care System?”

Among the myriad answers to those questions lies the germination of this blog.  Its purpose will be to discuss the successes, challenges, opportunities, and experiences of this organization from the early years through to our current state.

• We’ll discuss individual wound healing, including prior history, and healing trajectory while on the program.
• We’ll discuss, what happens to programs in different types of health care settings.  From Long Term Care to Home Health, from Vertically Integrated Systems to Solo-Practitioners, and from private payers to state Agencies, we’ll talk about how individuals and organizations vary in their approach to evaluating change.
• We’ll talk about how care gets paid for in a variety of settings and how the “tools” of care are reimbursed or not within those same settings.
• Science and evidence will be a part of the message as we address questions like “why haven’t you done a study, where are your studies?” and what that means to the multitude of people asking those questions.

In short, we’ll talk about all the things that we’ve experienced over the past several years from the beginning of the idea for an outcomes-based wound healing program through to our current state.

Look back here for periodic changes and additions to the material.  Our goal with this material is to provide a window for viewing the health care system’s inner workings and the points where the workings – don’t.