AI in wound: Delivering advanced care through a national wound registry

In the UK, one in 50 adults is living with a chronic wound,¹ leading to more than £8 billion in healthcare costs in 2017/2018.² However, these numbers are likely to be higher since the pandemic as a result of reduced care in 2020 and 2021 contributing to worsened patient outcomes.

The treatment of chronic wounds is labour-intensive and complex. They result from impaired blood flow in damaged or diseased leg veins, leading to complex physiological changes that result in skin breakdown and poor healing. Venous leg ulcers (VLUs), in particular, are often long-lasting, have a high risk of recurrence and have negative impacts on patient quality of life. In the UK, complex wounds are mainly treated in the community by nursing teams.

The challenges associated with wound care

In the UK, wound care is estimated to consume up to 65% of community nurses’ time due to the unpredictable nature of wound healing. Wounds that have not been appropriately managed are at a greater risk of becoming chronic and, for many patients, healing is a slow process. Only 53% of VLUs heal within one year and some never heal at all. Recurrence rates are also high - estimated at 57% by one year, leaving many patients suffering on an ongoing basis. Early identification and intervention are therefore critical in preventing wounds to protect patients’ quality of life and reduce the financial burden for the patient and healthcare system.

Low patient adherence to standard of care (SoC) is another factor that adds further complexity to wound management. Compression therapy is the current SoC used to treat VLUs, which make up approximately 80% of all leg ulcer cases. Despite being effective for some patients, many find this compression therapy uncomfortable due to their compromised vascular system. These patients will subsequently be treated with inadequate light bandaging to manage their VLU, but this often sacrifices an effective healing process.

Patient adherence to SoC is reported to lie between 12% and 52%, however, more recent and accurate data on the current state of adherence is required to drive improved outcomes moving forwards. With this in mind, opinion leaders and providers in wound care are unified in wanting a data-led approach to wound management and treatment, to help improve patient outcomes.

Building a national wound registry

Due to a lack of accessible patient data and treatment history, patients may receive conflicting healthcare advice from wound care professionals. Most patients will receive frequent care from community nurses in the clinic or home setting to clean and redress wounds, along with hospital visits to see hospital-based tissue viability nurses or vascular specialists. However, different clinicians or inexperienced community nurses may provide conflicting treatment recommendations, which can be frustrating for everyone involved and have negative impacts on healing outcomes.

Improved data collection is therefore required for transparent treatment history to help improve the consistency of care provided and deliver more personalised treatment plans better suited to specific patient needs and medical history. This would also inform clinical research in wound care and help drive the adoption of innovative medical technologies to enhance treatments. The benefits of having access to such data have been shown in Wales, where a national wound registry has been built to better support healthcare professionals in delivering more efficient and timely care to wound patients and improve the quality of research in the sector.

Through this unified approach, patients and clinical teams can work together to determine appropriate treatments and share healing progress and other health information, such as Patient Reported Outcomes Measures (PROMs). As suggested by Mölnlycke, a wound registry should include quality of life questionnaires to better support patients through the emotional and physical burden of living with chronic wounds. A common wound management approach allows clinicians to understand what interventions work well to ensure patient health is always improving.

How AI can contribute to healthcare

Artificial intelligence (AI) is becoming an increasingly valuable tool in healthcare to automate data-heavy tasks. Typically, patient data is reviewed and analysed by medical professionals and clinical teams to identify any patterns or anomalies – but this is a very time-consuming and labour-intensive task. With AI in place, a range of healthcare tasks can be made more efficient, such as data entry, analysing electronic health records, and supporting clinical decision making. In these ways, AI can free up the time of healthcare professionals and make clinical research more efficient, enabling faster adoption of new and improved treatments into care pathways.

With correct use, AI could eliminate a lot of the pain points currently facing wound care, whether that is the analysis of a patient’s medical history, data collection of a patient’s journey towards healing, or automated alerts for any causes for concern. AI is already being implemented by various players in healthcare, from diagnosis and prevention to treatment recommendations. In an industry struggling with workforce retention, the implementation of AI would not be introduced to replace jobs, but to support existing healthcare professionals in delivering excellent care to patients.

Advancing wound care for a better future

Complexities such as labour-intensive treatment, low patient adherence, and lack of clinical data all highlight why there is a need for innovation and a streamlined approach to wound care. Through embracing AI to automate data collection and organisation, healthcare systems can gather valuable insights to drive improved patient outcomes and save significant funds. Access to such data, if managed safely, will help clinicians conduct life-changing clinical research, paving the way for a brighter future of wound care.

1. https://publicpolicyprojects.com/wound-care/
2. https://bmjopen.bmj.com/content/10/12/e045253