It’s time to switch to a faster, more efficient way of assessing hyperbaric oxygen therapy
Patient-centered care remains the core focus of advanced wound care clinics, but how can the surrounding environment be optimized for that?
Adopting technology and devices that give physicians the most reliable, actionable output can give back valuable time to both providers and patients. Near-infrared spectroscopy (NIRS) is an advanced technology that measures tissue oxygen saturation (StO2).
Kent Imaging’s SnapshotNIR uses near-infrared wavelengths of light, pointed at the patient, to gather data on oxygenated and deoxygenated hemoglobin within their microcirculation up to 3mm below the surface of the wound. Data can be collected on any area of the body with varying levels of melanin content in the skin, expanding the number of patients that can be assessed. Without touching the patient, this non-invasive, handheld device presents a color-coded oxygenation map of the wound bed and peri-wound, allowing physicians to make bedside decisions regarding eligibility for hyperbaric oxygen therapy (HBOT) and the ongoing efficacy of the intervention.
How does NIRS compare to TCOM?
TCOM electrodes on the surface of a patients foot.
NIRS can gather data one step further in terms of physiological output as compared to the traditional method of assessment for HBOT, transcutaneous oximetry (TCOM). Oxygenation and perfusion seem similar, however, TCOM is missing important insights when it comes to wound healing and HBOT effectiveness.
Due to the necessity to heat TCOM electrodes that are on the skin of the patient, the output values from the TCOM device may be altered, and they only collect information on the amount of oxygen that diffuses to the superficial skin during the assessment. The data collected is limited to the location of the probes which is unable to be within the wound bed, and the output is extrapolated to provide an estimate of oxygenation values within the wound.
Research has confirmed that NIRS correlates well with TCOM values (Bowen et al 2016), but the quality and actionability of the collected data differs. Having the option to interpret hemoglobin values, alongside wound bed StO2, is unique to SnapshotNIR. As a patient continues through their HBOT dives, the physician can view the rising trend of oxyhemoglobin and the decrease of deoxyhemoglobin representing healing tissue. On the screen, at the point-of-care, patients will see this improvement as a change from more blue areas to more red areas, allowing them to understand why they require the prescribed number of HBOT dives.
How will SnapshotNIR improve clinical practice?
To improve efficiency across the patient interaction, image-taking with SnapshotNIR can be delegated to team members who can be trained on the device in a short amount of time. The point-and-click ease of SnapshotNIR doesn’t require the same time-consuming learning curve or application of TCOM. Incorporating this technology into a clinical workflow can be as simple as a single team training on running the device, and the physician can interpret the results at the bedside. The patient can be comfortable throughout the entire process, developing rapport and trust in the physician, leading to increased adherence to prescribed dives, keeping the hyperbaric chambers full. The entire process improves the healthcare cycle revenue management of the clinic, without reducing quality of care or increasing workload for the providers.
How will SnapshotNIR save time?
It is well-known that insurance companies require “i’s” to be dotted and “t’s” to be crossed when it comes to covering patient’s HBOT. Documenting TCOM results following a 45-minute assessment, and after completing a dive is not sustainable for a busy practice. SnapshotNIR shortens the assessment time to capture an image pre- and post-intervention, indicating if a patient is a ‘responder’ demonstrating a significant change in StO2. Once a patient is identified as a candidate for HBOT by using SnapshotNIR, the images and StO2 values are saved and can be used as convincing documentation for insurance companies to cover the required number of dives, request additional treatment, or show when maximum intervention benefit has been achieved and treatment can be completed.
Administration tasks, like documentation, shouldn’t take up the majority of the physicians’ time. SnapshotNIR streamlines the entire process from the assessment to patient intervention adherence, to monitoring and wound healing. With the clunkiness and outdated nature of TCOM, many physicians prefer to use SnapshotNIR.
Dr. Misael Alonso, MD, speaks directly to how these benefits have changed his clinic’s practice for the better, “Prior to using the Snapshot device, we had the option to perform TCOM to determine if a patient’s wound would benefit from hyperbaric oxygen therapy. But TCOM can take a long time,” says Dr. Alonso. “Now, with Snapshot, I can take a picture and get a result within mere seconds. So, we no longer use TCOM here at the clinic; we only use the Snapshot device.”
The immediate evidence of intervention efficacy can completely change the course action for patients. Dr. Alonso has been using SnapshotNIR in his practice to reduce amputations and in one instance, an insurance company had declined further coverage for a patient for HBOT sessions even though there was clear improvement in the patient’s condition. “Thankfully, I was able to show [the insurance company] the Snapshot images that were taken before the patient went into the hyperbaric chamber and after the patient came out,” says Dr. Alonso. “Those images, along with the wound measurements captured by the device, all showed great improvement. Because of this proof, HBOT was approved for 30 more sessions, and the patient is walking on his own foot to this day.”
“Because of this proof [from SnapshotNIR], HBOT was approved for 30 more sessions, and the patient is walking on his own foot to this day.”
The implementation of SnapshotNIR to confirm HBOT eligibility, monitor treatment effectiveness and save time for physicians can be a game-changer. FDA-cleared and meeting all cybersecurity requirements, SnapshotNIR is used daily across the United States in the hands of excellent clinicians.
Read the entire customer success story from Dr. Alonso here.
References:
Bowen, R.E., Treadwell, G.R.N., Goodwin, M.R.R.T. (2016). Correlation of Near Infrared Spectroscopy Measurements of Tissue Oxygen Saturation with Transcutaneous pO2 in Patients with Chronic Wounds. SM Vasc Med; 1(2): 1006.
TCOM image: Mousa, A.Y., Ballard, J.L. (2022). Transcutaneous Oxygen Tension: Principles and Applications. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-60626-8_55