To help monitor and guide the treatment of diabetic foot ulcers and other chronic wounds, Dr. Brem’s team has developed and pioneered the use of a comprehensive Online Wound Electronic Medical Record (OWEMR) that incorporates up to 137 medical variables for each patient. The OWEMR’s important features include a highly effective one-page summary of all key factors in each patient’s condition, as well as a system for automatically alerting the patient’s medical team whenever the record indicates the emergence of a potential problem.
The OWEMR has proven to be an invaluable tool for assessing the progress of individual patients, and for alerting all relevant caregivers when a diabetic foot ulcer is on the verge of developing a dangerous complication or when its healing process has plateaued, signaling the need for an additional surgical debridement and reapplication of regenerative therapies. It also presents a real-time, single-screen summary of the information most relevant to each patient’s wound healing, including:
Finally, the OWEMR’s built-in treatment protocols can also be used to help disseminate Newark Beth Israel’s state-of-the-art diabetic foot ulcer therapeutic program to other wound centers in the U.S. and elsewhere. Trials are currently underway to evaluate the OWEMR’s effectiveness as a clinical decision support tool.
Our OWEMR uses a secure online system that allows its information to be accessed over the Internet by any approved healthcare provider in a hospital, clinic, nursing home or community setting who has a computer with secure Internet access. At the same time, security safeguards keep all information private and protected by denying access to anyone without pre-authorized clearance.
One of the OWEMR’s most valuable features is an intelligent “search and report” capability, which enables it to be programmed to send out immediate, automatic alerts via e-mail and Blackberry to all key medical personnel if a patient fails to achieve and maintain a minimal healing rate (in which case we will schedule a debridement procedure), or if the patient develops a limb- or life-threatening complication, such as new or increasing wound pain, cellulitis, purulent drainage, and/or presence of significant undermining—all of which may indicate an invasive infection. Patients with these symptoms typically require emergency treatment in order to prevent progression to sepsis, amputation, and potentially death.
Our clinical experience has proven the value of this alert system many times over. In one study, recently presented at the 96th Annual Clinical Congress of the American College of Surgeons, use of the OWEMR was directly associated with reduced likelihood of limb loss from a diabetic foot ulcer.