Silhouette Digital Wound Imaging, Assessment & Information Management System (#1894)

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Innovation 'Elevator Pitch':
Electronic wound imaging, assessment & information management system.  An enabling technology to support objective wound assessment, monitoring & evidence-based treatment for patients with chronic & acute wounds such as diabetic foot ulcers.
Overview of Innovation:
Silhouette is an easy-to-use wound imaging, 3D measurement & documentation system providing accurate wound information at the point of care to support effective clinical management of patients. Silhouette wound informatics are available as a wound assessment PDF report and on a secure web-enabled database and for easy access and sharing across the entire care team. 

The wound images and wound healing progress charts are highly visual and provide immediate and clear indication of a patient's response to treatment.

This award-winning system includes an imaging 3D camera that precisely and consistently measures the area, depth & volume of wounds to track and report healing progress. Silhouette enables wound assessment activity and wound outcomes to be monitored, providing wound information that is available instantly to key stakeholders, integrated with your EMR system. Silhouette is proven in both clinical research & clinical practice.

Silhouette supports pro-active management of wound-related risk & improves communication, helping practitioners to be more productive & effective in their delivery of wound care. Silhouette is suitable for all settings, including acute out-patient clinics, community-based care, home health & telehealth wound care.

The Silhouette system is made up of three main parts – a point of care wound camera, smart software for measuring wounds, & a wound information database:
  • The SilhouetteStar® specialized camera (pictured right) captures the wound image;
  • SilhouetteConnect® software for accurate 3D measurements of the wound based on the data acquired by SilhouetteStar (see below), together with healing progress charts & electronic wound assessment summary reports. 
  • SilhouetteCentral®, a secure Internet-accessible database that stores & consolidates the information obtained from the organisation’s SilhouetteStar + SilhouetteConnect devices, including integration with the EMR.
Unlike non-3D and traditional methods, which are imprecise & unreliable, Silhouette provides meaningful information for better clinical decisions. It is also extremely easy to use & is ready to integrate with EMR systems. Silhouette was first established in clinical research, which requires rigorous source documentation, & is now available for widespread use in clinical practice.



Stage of Development:
Market ready and adopted - Fully proven, commercially deployable, market ready and already adopted in some areas (in a different region or sector)
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See update on EMAHSN Technology-enabled transformation of Diabetes Foot Service.  A great success story of EMAHSN, NHS Partners and industry working together to deliver improved diabetes foot care in the East Midlands. This digital telehealth solution (Silhouette) supports improved diabetes foot service access and reduced costs and is ready for replication across the NHS. Come and see us at the Entec Health, Silhouette stand at Meridian Live on Wed 15th February, Birmingham event. We look forward to partnering with NHS Innovators in the West Midlands to transform management of diabetes foot ulcers, pressure ulcers, leg ulcers and complex wounds to support better patient experience and outcomes.
http://info.entechealth.com/entec-health-transforming-diabetes-foot-care
Watch this 3 minute BBC Regional News Report to find out how the EMAHSN Diabetes Foot Service, enabled by Silhouette, is improving service access, patient experience and joining up integrated diabetes foot care. This solution supports NHS Providers to comply with NICE Guidelines for managing patients with diabetes foot ulcers by enabling rapid escalation/de-escalation and MDT management based on objective DFU progress data. A key clinical goal of diabetes foot care is to achieve rapid healing of foot ulcers to prevent secondary complications such as unnecessary amputations.
Watch the video: https://vimeo.com/195309682
Entec Health is proud to let everyone know that a successful Silhouette telehealth demonstrator has been established for the management of patients with diabetes foot ulceration.  
The initiative is supported by the East Midlands Academic Health Science Network.
This Silhouette technology-enabled initiative went live in July 2016 in the Royal Derby Hospital out-patient clinic and in the Derbyshire Community Healthcare Services Trust in Sept 2016. 
The EMAHSN Diabetes Foot digital solution is releasing pressure on an over-booked out-patient DF clinic, improving access to MDfT care and reducing tariff costs across the integrated pathway. The patient response has been very positive to the reduced travel time, wait time and convenience. The Derbyshire team are now working on securing funding for expansion of the model to additional community sites. 
See EMAHSN Press Release: http://emahsn.org.uk/diabetes/projects/
As someone who regularly seems to suffer injuries to my shin, which take ages to heal, I can see how valuable this wil be in the management of wounds, particularly during home care, where things can change rapidly and the same person may not see you twice. There may also be potential for the patient to use it themselves and only upload images where they feel there's cause for concern' it's getting more painful or is weeping for example. Integration between information generated from home based devices and patient records could reduce the number of home or clinic visits required during the healing process, especially when it's well underway and at low risk of complications.
Mary,
Many thanks for taking time to review the Silhouette pages and your comments. You make a very valid and ineresting point about patient's use of the technology. Silhouette is designed for use by clinicians such as podiatrists and wound care nurses, in close partnership with their patients. We have observed that the the wound healing chart, which shows wound size change over time, is really useful visual tool for clinician and patient to discuss response to treatment and support joint care planning and compliance. 
There are two case studies on the ARANZ Medical website I can share to illustrate the patient empowerment that is possible with Silhouette wound data - please see: http://www.aranzmedical.com/patient-wound-outcomes-sdhb/
As you have recognised, Silhouette lends itself to  mobile working based on using the camera and software on a tablet/laptop. The digital wound data captured by the device patient-side can then be made available on a central information platform for review by users with permission at different care locations, enabling a remote consultation/telehealth set-up. As you say, this has the potential to allow patient wound data to reach the care team without unneccesary visits to hospital. 
I am working on new case studies based on new early adopters of Silhouette in the NHS and will be sharing those in coming weeks. 
 
Great product for accessing and monitoring patients at home or in the community / GP clinic - Thus monitor and accurately measure the gradual or rapid increase or hopefully decrease of the wound size. This tool I would imagine to be of great use where community nurses and care professionals may not see the same patient on a regular basis and thus not have a clear idea of how good or bad it was when the patient was last visited from the hand written notes.

This device would give a direct measurement for the clinician to be able to make a judgment call, on if additional specialist intervention was required prior to sending them off to a wound care / pressure sore specialist centre and thus the NHS incurring all the costs (which may be unnecessary) and the potential discomfort the patient may endure along with the possible complications of getting to a clinic for either the patient or their carers to organise.
Chris,
Apologies, I have noted this comment very late in the day. Many thanks for your comments which really hit home on the potential value of the Silhouette innovation. The digital wound healing data generated by Silhouette, such as change in area, volume and depth is available to the clinician conducting the assessment with Silhouette at point of care and also once uploaded,  on the central database hosted on the Trust/ Oganisation's server. This means that the entire care team can review a patient's digital wound assessment and outcomes data to confirm if the patient's wound is progressing well or if a review is needed by an appropriate specialist. There is definite scope to increase effectiveness and efficiency of current wound managmeent practice and target reduction in costs.

 
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