Parable is a software platform that allows doctors and home health workers to collaboratively monitor wound healing and to flag any issues. The technology has been designed by Parable Health and allows doctors to assess wound parameters and healing progress from “smart” photos taken using a phone’s camera. The doctor can schedule virtual check-ins with the patient. The idea is that this will reduce transportation costs in bringing patients to and from health care facilities for regular checkups, streamline data collection, and allow for collaborative care between various healthcare professionals. The technology allows wound size and topography to be measured easily and in a standardized way. The system can also provide alerts to helps doctors care for the most urgent or vulnerable patients. The technology is not just conceived for home use, but is also designed to be used in in-patient units, surgery departments, and for research.
Medgadget had the opportunity to ask Nathan Ie, Founder of Parable Health, some questions about the technology.
Conn Hastings, Medgadget: What types of wounds require long-term monitoring and care? Does this include diabetic ulcers?
Nathan Ie: You’re exactly right, Conn. Diabetic ulcers, venous and arterial ulcers, and pressure injuries (aka bedsores) are all examples of chronic wounds that require careful monitoring and care – often over several months and in some cases, years.
Now you mentioned diabetic ulcers specifically. Along with pressure injuries, diabetic ulcers represent the largest segment of chronic wounds. Out of the 30 million diabetics in the US, about a quarter will develop diabetic foot ulcers and around 15% of these cases will result in amputation…so it’s a big deal. And on a global scale, when you think about the fact that almost 9% of the world’s population suffers from diabetes (a population that’s quadrupled since the 80s by the way), the sheer scale of the issue is enormous.
Medgadget: What are the risks associated with poor wound management? Can things get out of control quickly?
Nathan Ie: Chronic wound care is the healthcare crisis most people don’t know about – affecting more patients than congestive heart failure.
If not properly managed, wounds can result in infection, reopenings, readmissions, amputation (as I mentioned earlier), and death. One of the most sobering statistics I’ve ever come across is that every 30 seconds there’s an amputation due to a diabetic foot ulcer. And did you know Christopher Reeves (yes, Superman himself) struggled with pressure ulcers, and ultimately died from complications linked to pressure ulcer infection?
Medgadget: How does the system work? Does the patient take a photo of the wound themselves, during a virtual check-in with a doctor? How easy is the system to use?
Nathan Ie: Well, we operate across the continuum of wound care and across different healthcare settings – which means we have solutions for monitoring recovery for post-surgical wounds (most commonly in ambulatory departments) all the way to chronic wound management in inpatient and post-acute settings.
When it comes to ambulatory settings, that’s right – patients are discharged with Parable on their own mobile device, and prompted to perform “virtual visits” during their recovery. And yeah, it’s a snap. One of the reasons we’ve been able to expand to other departments is because docs have been telling their colleagues how easy it is. And on the patient side, our surveys show about a 97% rating on ease-of-use – which we’re quite proud of.
For chronic wound management, clinicians are the ones using Parable to measure, monitor, and manage their wound population. Its computer vision technology meets standardized protocols, paired with collaboration tools, actionable analytics and alerts.
Medgadget: What parameters can the system measure? What do these tell a doctor about the wound progress?
Nathan Ie: The platform can automatically track wound measurements and other clinical elements such as exudate levels, necrotic tissue amount, etc. On an individual level, Parable informs care teams if wounds are on a healing trajectory and if the current care plan is working. On a macro level, the platform helps care teams intervene on that 5% of their population that’s driving 50% of their cost. This means identifying the most at-risk patients for better resource allocation.
Medgadget: How does the system help with collaboration and standardization in wound care?
Nathan Ie: Those are actually two incredibly relevant words in the world of wound care, Conn.
Collaboration is relevant because it’s common for wound patients to be cared for by a variety of clinicians and passed across multiple settings. A single patient may end up receiving care from a hospital, outpatient wound clinic, and a post-acute care provider such as a home health agency or skilled nursing facility. Parable helps collaboration within an organization (e.g. a field nurse consulting a WOCN via our system) and across organizations (e.g. a home health agency sharing healing progress with the referring doc at the hospital using Parable).
And standardization is relevant because inconsistency is a big issue with wound care. Let’s just look at measurements – a critical part of wound care. Did you know the current standard for measuring wounds is a paper ruler and a q-tip? It’s crazy that we have pills with digestible microchips, but we’re still using paper rulers and q-tips to measure wounds. If you ask 5 clinicians to measure the same wound you’ll likely get 5 very different measurements. And even the same clinician’s measurements can vary wildly between visits (e.g. measuring from a different orientation). Parable solves the standardization problem with computer vision technology and standardized frameworks to consistently measure and assess wounds, no matter which clinician is at the bedside.
Medgadget: How can the system be used for research?
Nathan Ie: Mainly in clinical trials – not only for more seamless and standardized study documentation, but also for more convenient collection of patient-reported outcomes. The former is particularly relevant in studies that have visual elements as primary or secondary endpoints. The latter for studies that require remote image submission or more longitudinal patient reporting between on-site visits.
Link: Parable Health…
