INNOVATION IN ACTION
When it comes to ensuring exceptional outcomes for wound care, Dr. Doug Toole and Dr. Taylor Wright know first-hand that a picture is worth a thousand words.
As partners and co-owners of Innovation Medical Group, the doctors, based in Salt Lake City, Utah, specialize in podiatry, but they also deliver wound care to patients who are dealing with diabetic wounds, leg wounds and pressure ulcers.
“Our main focus is full-body wound care, advanced wound care and associated comorbidities,” explains Dr. Toole. “We want to achieve really sophisticated, exceptional outcomes for these very difficult-to-treat, advanced wound care patients.”
Of course, it’s a lot easier to achieve those exceptional outcomes when patients are actively engaged in their own treatment plans. And one of the most powerful ways to attain that buy-in is by showing them—not just telling them—the reasons behind a particular course of action.
That’s why, when Dr. Toole and Dr. Wright heard about the SnapshotNIR (Kent Imaging) device through one of their trusted wound care vendors, they were immediately intrigued and decided to give it a try.
The latest advancement in non-invasive, portable imaging, SnapshotNIR uses near-infrared light to provide real-time visualization of microvascular tissue oxygen saturation, allowing clinicians to identify and track the viability of tissue in wounds, and to easily demonstrate and document the success of treatment modalities.
“[After learning] about SnapshotNIR, we wondered, ‘Is this advanced imaging device going to help us as much as we think it is? We really thought it could demonstrate to patients the process of healing, or their disease state, and then help them to follow compliance with our treatment algorithms’” recalls Dr. Toole.
“Well,” he adds, “it has certainly done all of those things.”
Increasing Engagement
Today, SnapshotNIR has become a standard of care at Innovation Medical Group, which has offices in several states throughout the western U.S. Whether they are seeing patients at one of their clinics or working remotely, Drs. Toole and Wright and their staff use the device regularly to assess and track the tissue oxygenation of a patient’s wound site and subsequently develop a plan for treatment.
“The nice thing is, through this sophisticated imaging, not only can you [measure oxygenation] and track the progress of healing, you can see and record the oxygenation percentages at any point,” says Dr. Wright. “You can absolutely track this oxygenation progression and the size. You can take care of a patient pretty efficiently, just with this one device.”
“And, you know,” he adds with a smile, “the patient is always interested in the colors.”
Indeed, it’s the colors in the Snapshot images—red demonstrates the highest levels of oxygenation, blue is a sign of insufficient oxygenation—that often prove to be the most effective way of demonstrating to patients where they’re at with their condition and healing.
“One of my cases that I really like was a lady with memory care issues,” says Dr. Toole. “She came to the clinic with a pinpoint ulceration on the side of her foot, against the bony prominence, and it extended all the way down to just about her bone.”
The wound was so hard to see with the naked eye, however, that the patient had difficulty even comprehending that it required attention.
“But I was able to take a picture of it with the Snapshot device and show her the decrease in oxygenation to her whole foot and especially that area, which came up essentially blue,” says Dr. Toole. “And in seeing all that blue, she was able to understand that the tissue was dead there.”
The colors in the Snapshot images were enough for the woman to grasp the severity of her wound. And throughout the ensuing treatment course, as more red and orange areas began to emerge, she was able to see—and understand—that things were getting better.
“We could see that area start to light up on the device, until the point where we could tell that the wound itself had become viable, even relative to the surrounding tissues,” says Dr. Toole.
Over the course of treatment, this cognitively challenged patient remained both engaged and compliant with her care, thanks in large part to those increasingly encouraging SnapshotNIR images. And she’s one of many; both doctors maintain this level of patient engagement is a common theme with the imaging tool.
“We really have seen patients be in awe of the technology, and very motivated to continue their treatment,” says Dr. Wright.
Illustrating Efficacy
It’s not just the patients who are in awe. Fellow practitioners in the medical community who are unfamiliar with SnapshotNIR and its capabilities have been just as taken aback when Dr. Toole or Dr. Wright introduce them to the device.
“All of them, without question, are extremely surprised and impressed that such a device exists, that we have it in our practice, and that we’re able to use it on their patient and illustrate efficacy of treatment,” says Dr. Toole.
But awe doesn’t necessarily translate to instant buy-in from peers, as Dr. Wright can attest.
“We had one patient, a diabetic, who was referred to us by an ER doctor in one of the local hospitals,” recalls Dr. Wright. “The patient had fallen a month or two earlier, and he had a flap of tissue that, in the emergency room, they stitched and closed back onto a pretty large wound that encompassed a portion of the whole left front aspect of his lower leg.”
By the time the patient came to Innovation Medical, the wound still was not healing and didn’t look good. The first thing Dr. Wright did was take a “snapshot” to show the patient that there wasn’t sufficient oxygenation.
“I explained to him what we were looking for, and how the SnapshotNIR image gives us a percentage of the oxygen getting to that flap or to the wound. The image came up blue, telling us, ‘Hey, this is not getting the oxygen that we would want for the flap to heal.’ He was pretty amazed [at what he was seeing].”
Dr. Wright also shared that image with the referring ER doctor, who was unfamiliar with near-infrared imaging technology and wasn’t immediately swayed by the suggestion that they remove the flap right away. The doctors agreed to leave the wound alone for one more week.
“But the proof was in the pudding,” says Dr. Wright. “After a week, you could see the flap was not going to heal. It wasn’t getting sufficient oxygen. So we removed it and were able to clean up the wound as it needed to be. And that urgent care provider, after I showed him [the wound without the flap], was pretty blown away. He said, ‘Well, you’ve proven it to me. It sure would be nice to be able to use that Snapshot all the time [in the ER].’ It was great for us, because in a way we gained his trust in the process.”
The best part for Dr. Wright, though, was seeing the boost in that patient’s morale: “Each time this patient comes in now, he wants to make sure we’re taking that image. He loves to see how, after having that wound for so long, he’s finally on his way to healing. That’s fun to watch.”
Technology in Motion
For patients and doctors, alike, there’s nothing quite as galvanizing as seeing progress in healing. And for the team at Innovation Medical Group, SnapshotNIR has become the primary tool for showing both patients and caregivers the physiologic improvements of a case.
“Snapshot is very cohesive with our techniques and our mission to increase an advanced level of imaging diagnostics and care therapies to patients, and to mobilize that,” says Toole, who notes that many of Innovation Medical’s patients are homebound and unable to come into a clinic.
The fact that the tool is lightweight and portable makes it that much easier to provide quality care in mobile settings. Indeed, the device’s transportability is a valued feature for the doctors, who continue to expand their territory and are always looking for ways to become a more nimble practice.
The company now owns four SnapshotNIR devices, all of which are used on a daily basis.
“From a management standpoint, this is a very profitable device to have and utilize, so that’s really a win win,” says Dr. Toole. “It’s good for patients, and it’s sustainable for a medical practice to use regularly.”
Drs. Toole and Wright, co-owners of Innovation Medical Group.
If you would like to share your experience with SnapshotNIR through an Ask the Expert interview or Customer Story, contact Kent Imaging via email for more details or call TF: 1-833-SEE-KENT (1-833-733-5368)