Diabetics have a new tool to aid in the difficult â€” and expensive â€” battle against foot ulcers and ultimately amputations.
Savannah digital healthcare IT and wound management firm Corstrata recently introduced their new diabetic foot ulcer and amputation prevention solutionÂ â€” an app, a smart thermometric foot mat and telehealth communications with board certified wound clinicians.
Corstrata was founded in 2015. It offers a Comprehensive Wound Care Management Program, wound patient consultations, and specific services such as wound program assessment, formulary design, treatment guidelines assessment, wound documentation review, and practitioner education.
Corstrata co-founder and CEO Katherine Piette said diabetic foot wounds are a huge problem.
â€śOne out of four diabetics will get a foot ulcer,â€ť Piette said. â€śAnd one out of four of those will have an amputation.â€ť
Once a patient has a foot ulcer, the costs rack up, she said.
â€śEach ulcer costs about $44,000 to treat,â€ť Piette said.
Piette said that more than 30 million people in the United States have diabetes and more than 1.7 million have a new diabetic foot ulcer (DFU) each year, with a 40 percent re-ulceration rate.
Diabetic foot ulcers can also lead to an increased risk of death, Piette said.
â€śThe risk of death at five years for DFU patients is 2.5 times as high as the risk for a diabetic patient without a foot ulcer,â€ť Piette said. â€śIf you can prevent it from the beginning you may be adding years to your life.â€ť
How it works
Corstrataâ€™s prevention program starts with less than a minute of the patientâ€™s time.
â€śThe patient steps on a smart mat every day for 20 seconds,â€ť Piette said. â€śThe mat takes a thermographic photo that can detect hot spots.â€ť The thermometric mat is the only remote temperature monitoring technology with FDA clearance.
Hot spots are an indicator of an impending DFU. The mat can detect a DFU about five weeks before the wound opens, Piette said.
â€śItâ€™s been known for years that increased temperatures were an indicator of possible inflammation,â€ť Piette said. Inflammation can then lead to ulcers.
Information collected by the smart map is analyzed for hot spots.
If a hot spot is found, the patient is contacted for a treatment plan that includes the use of an off-loading shoe. The shoe helps relieve pressure against the hot spot, giving it time to return to normal.
Piette said much of what is known about wounds comes from research done at the Carville, La., Leprosarium in the 1970s.
The site is now The National Hansen’s (leprosy) Disease Museum honoring once-quarantined leprosy patients and the medical staff who cared for them.
â€śThere are similarities in leprosy and diabetes,â€ť Piette said. Both diseases feature a loss of sensation in the feet.
Diabetic patients get foot ulcers from pressure and poor shoes, Piette said.
â€śThey also have peripheral neuropathy,â€ť Piette said.
PeripheralÂ neuropathy is the result of nerve damage and can cause numbness.
It can also cause patients to inadvertently cause themselves trouble.
â€śSome diabetics donâ€™t even know they have a foot wound,â€ť Piette said.
High glucose levels and poor circulation from diabetes contribute to making the wounds difficult to treat.
Corstrataâ€™s app does more than detect hot spots.
â€śWe talk to patients once a month (in all cases),â€ť Piette said. â€śThere is a lot of patient engagement.â€ť
Through the app, patients can also view educational videos, receive texts and documents, and have a live video visit with caregivers. The app will work on any smart device and is HIPAA (Health Insurance Portability and Accountability Act of 1996) secure for privacy.
Using Corstrataâ€™s solution to prevent DFUs has a multitude of benefits, company co-founder and Chief Financial Officer Joseph Ebberwein said.
â€śResearch indicates that the use of early detection technology, coupled with evidence-based interventions, can prevent 75 percent of foot ulcers in this high-risk population,â€ť said Ebberwein,
Ebberwein said that prevention solutions are also a time and money saver.
â€śLower extremity amputation studies and clinical trials have shown that diabetic foot ulcer and amputation prevention solutions can greatly reduce costly hospital visits and procedures associated with ulcerations and amputations,â€ť Ebberwein said.
Currently the prevention app cost is paid by insurers who identify at-risk patients, Piette said.Â
Once a patient is signed up for the program by their insurer, they are sent a link for the app.
Whether or not patients are clients, Piette has two important reminders for all diabetics.
â€śThe worst thing you can do is go barefoot,â€ť Piette said. â€śAnd when you visit your doctor, go ahead and take your shoes and socks off so no one forgets to check your feet.â€ť