JMIR Publications

ABSTRACT

Background:

The demand for home health (HH) care and nursing visits has steadily increased, requiring significant allocation of resources for wound care. Many HH agencies operate below capacity due to clinician shortages, meeting only 61-70% of demand and frequently declining wound care referrals. Implementing Artificial Intelligence (AI)-powered digital wound care solutions (DWCS) offers an opportunity to enhance wound care programs by improving scalability and effectiveness through better monitoring and risk identification.

Objective:

This study assessed clinical and operational outcomes across 14 HH branches that adopted DWCS, comparing pre- and post-adoption data and outcomes with 27 control branches without the technology.

Methods:

This quasi-experimental study with pre-post comparative design analyzed clinical outcomes, including average days to wound healing, and operational outcomes such as skilled nursing (SN) visits per episode (VPE) and in-home visit durations, during two seven-month intervals (November-May 2020-2021 and 2021-2022). Data were extracted from 14,278 wound care patients across adoption and control branches. Projected cost savings were also calculated based on reductions in SN visits.

Results:

The adoption branches showed a 4.3% reduction in SN VPE and a 2.5% reduction in visit duration, saving approximately 309 staff days. In contrast, control branches experienced a 4.5% increase in SN VPE and a 2.2% rise in visit duration, adding 42 days. Healing times improved significantly in the adoption branches, with a reduction of 4.3 days on average per wound compared to 1.6 days in control branches (p<0.001), with pressure injuries, venous ulcers, and surgical wounds showing the most substantial improvements.

Conclusions:

Integrating digital wound management technology enhances clinical outcomes, operational efficiencies, and cost savings in HH settings. A reduction of 0.3 SN visits per episode could generate annual savings of up to $958,201 across the organization. The adoption branches avoided 1,187 additional visits during the study period. If control branches had implemented DWCS and achieved similar outcomes, they would have saved 18,546 healing days. These findings emphasize the importance of incorporating DWCS into wound care programs to address increasing demands, clinician shortages, and rising healthcare costs while maintaining positive clinical outcomes.