In this episode, we’re pleased to welcome Brian Litten, Chief Executive Officer of Swift Medical, to discuss burden to business driver, revolutionizing wound care through AI-powered technology.Learn how to listen to The Hospital Finance Podcast® on your mobile device.
Highlights of this episode include:
- About Swift
- Swift’s AI-powered platform
- Why wound care
- Benefit of using AI in wound care management
- Who uses Swift Skin and Wound
- Wound care management in five years
- Where or when are patients most at risk for wounds
- Why chronic wounds the number one risk factor for hospitals
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome Brian Litten. Brian is the Chief Executive Officer of Swift Medical, bringing 25-plus years of leadership experience within healthcare organizations, including payers and technology-based solution providers. As a recognized expert in healthcare strategy, growth, and policy, he is passionate about transforming the healthcare system to improve access to quality care, healthcare delivery, and patient outcomes. In this episode, we’re discussing burden to business driver, revolutionizing wound care through AI-powered technology. Thank you for joining us today, Brian.
Brian Litten: Kelly, it’s a pleasure to be here. Thanks for having me.
Kelly: Awesome. Well, let’s go ahead and jump in today. So, can you tell me a little about Swift? And what differentiates it from other companies working in wound care?
Brian: Well, Kelly, I’d be happy to. Swift solves a pervasive, expansive, and sorely neglected problem in our healthcare system, the problem of chronic wounds. When you think of chronic wounds, let’s try to understand exactly what we’re talking about. I’m sure you and most of your listeners are familiar with bed sores, which are actually pressure injuries. Pressure injuries come from individuals not being ambulatory, sitting in a chair, perhaps a wheelchair for too long, being in a bed for too long. The contact between the skin and another surface causes an injury to form, which becomes an injury that’s quite painful, causes a lot of complications, very difficult to treat, and becomes a big, big problem for the system. Another example of a chronic wound is a diabetic foot ulcer. As diabetic patients have more and more challenges with circulation, the lack of circulation to the extremities can cause a diabetic foot ulcer. You may see diabetic patients who have amputations. And unfortunately, amputation is the end result for a lot of these patients where their wounds were not successfully treated. So those are two examples of chronic wounds.
Swift is in the business of developing AI-driven technology to treat chronic wounds, to address these issues for the benefit of patients and for the clinicians that treat patients. And why is this so important? Well, according to HFMA, hospital-acquired pressure injuries, or HAPIs, as they’re called, affect 2.5 million patients per year in the U.S. The National Institutes of Health suggests that a single hospital-acquired pressure injury could cost $10,708 per patient on average. And that exceeds a total of about $26.8 billion in the U.S. based on an annual projected number of 2.5 million cases. With regard to foot ulcers, diabetic foot ulcers, about 2 million Americans develop a foot ulcer each year. And within five years of acquiring a foot ulcer, over half of those individuals die and 5% lose a limb. So Swift is the global leader in digital chronic wound management and is focused on improving clinical and economic outcomes through our groundbreaking AI-powered technology, again, all designed to help clinicians help their patients manage chronic wounds heal faster with better outcomes and lower costs.
Kelly: Thank you for sharing that information with us about Swift. And speaking of that, so what does Swift’s AI-powered platform do exactly?
Brian: Well, Kelly, one of the things that drew me to Swift– and thanks for the kind intro. I have spent my career in digital health looking at ways technology could be leveraged to address the needs of vulnerable and neglected populations. And certainly, those that suffer from chronic wounds fall into that area. One of the things that really attracted me to Swift at the outset was how differentiated its technology was from anything else in the marketplace and how they were solving a problem that no one else was really effectively addressing. Swift has developed software that you download from the App Store, and it essentially turns your personal device, a smartphone or a tablet, into a medical-grade diagnostic device. And it does this by leveraging, literally, space-age technology. The engineers who developed Swift eight and a half years ago were former aerospace software engineers who designed the same imaging technology used on the Hubble Telescope and the Mars Rover. And if you think about the sophisticated way that that imaging technology helps scientists understand the surface of foreign planets, and you suddenly apply that same technology to the surface of the skin, where wounds are the craters, you can understand how those craters change over time.
So, one of the biggest challenges in wound care is that wounds change in such small, imperceivable amounts, day-to-day, that it’s virtually impossible for a doctor or nurse to understand whether that wound is getting better or worse. One of the traditional ways of measuring wounds to understand whether they’re getting better or worse is a very manual process of using a paper ruler. And even the demarcations on a ruler at the smallest level of measurement still do not adequately help a clinician understand that wound path progression, whether the wound is getting better or worse. And when you take into account that different clinicians are measuring each day, there’s a lot of variability. And the lack of understanding leads to bad treatment. Because if you could understand at the point of care that a wound is getting better, you’re going to keep doing the same kind of treatment regimen that you were doing previously. If you understood that the wound was getting worse, you’re going to change the therapy. So with Swift, being able to look at that wound image and be able to document it, image it, the same way every day, regardless of the clinician taking the image, regardless of the lighting, regardless of body position, that image is consistently taken, and the area, the surface area, depth is calculated with such a high degree of precision that a clinician can see, very clearly for the first time, how their interventions are impacting a patient and what could be done incrementally to improve the treatment path.
Kelly: Wow, sounds like an impressive platform. So why wound care, Brian?
Brian: Well, there are two things. For the company, I think wound care made a lot of sense. As I mentioned, it’s a very, very costly issue. When we go beyond the world of hospital-acquired pressure injuries, pressure injuries in general are a huge issue. In the Medicare population, roughly 26 million individuals will experience a pressure injury during the course of a year. It’s a huge number. And with our population aging, that number is only going to increase. Across diabetes, and with chronic disease growing exponentially as well, especially diabetes, you’re seeing an extraordinary number of patients who are going through the hardship of dealing with diabetic foot ulcers. So, this problem is only going to get worse. And it is an area that has just not– where there’s been a dearth of innovation. So, it’s ripe for opportunity. And being able to take an area of healthcare that has been neglected and bring in the outside thinking of scientists who have modeled the surface of planets and apply that to the surface of the largest organ of the body, the skin, it’s a really, really powerful combination. And we’re able to make such an important difference in the lives of patients, but also in the lives of the clinicians that care for these patients. For me, personally, I’m drawn to this because, like so many other people, when you sit back and think about it, I, too, was touched personally by a wound-related issue. My own father passed away from a wound-related infection. It’s not uncommon. And if a tool like Swift had been available 13 years ago when my father was going through his experience, I wonder if the circumstances could have turned out differently.
Kelly: Yeah, no, that makes a lot of sense. So, what is the cost-benefit of using a platform like Swift’s?
Brian: In the U.S., based on the Medicare figures I shared previously, we’re looking at an annual cost, just in Medicare, of over $67 billion a year. When you take into account, too, that in Medicaid, which is slightly larger than the Medicare population, that you’re probably looking at the same prevalence or higher that you are in Medicare, you’re looking at maybe $120-$130 billion dollars of spend in the U.S. just between Medicare and Medicaid cases. And 27% – 50% of hospital beds are currently occupied by patients requiring wound care management. So, in terms of the ROI, with Swift, we’re looking at much faster recovery times, better diagnostic intervention times. And through the years that we’ve been in business, we’ve amassed a wound care data lake, over 20 million wound images, over 40 million patient encounters with longitudinal patient records. We have the largest wound database in the world. And our data scientists are now leveraging that to provide clinical decision support based on the lessons we’ve learned through the artificial intelligence, the learning through those images and the treatment paths, the best treatment protocols to suggest to clinicians at the point of care, which means that patients treated by clinicians using Swift are seeing recovery times that are 37% faster than in cases where they’re not using Swift. And this means that we’re also seeing correspondingly significant reductions in hospitalizations due to chronic wounds, reductions in lengths of stay, reductions in ER visits, and reductions in preventable hospital readmissions.
Kelly: And so what is the benefit of using AI in wound care management?
Brian: AI is a powerful way of taking lessons, millions and millions of lessons that have been learned over time – in our case, it’s our database of the 40 million encounters – and understanding, by looking at those through machine learning, which treatment protocols were the most effective for different kinds of wounds. So, by being able to present clinicians through the app at the point of care with these important clinical insights, we’re reducing the workload for doctors and nurses, and we’re making information easier to share. This helps patients recover more quickly from the wounds, and it also, as I said earlier, leads doctors and nurses to the best treatment options for a patient. It reduces human error. It reduces trial and error. And it guides clinicians to the best standards of care.
Kelly: Wow. That is substantial. So, who uses Swift Skin and Wound?
Brian: The technology is primarily used by clinicians, doctors and nurses. It’s used at various points of care. It’s used in places from skilled nursing to home health, but also importantly, it’s used in the hospital. It’s used in acute and post-acute settings. And I think that there are even more use cases, particularly when you think of the number of patients that present at the ER with wounds. There is opportunity there to help doctors and nurses triaging emergency cases to better direct wound care patients to the most appropriate site of care.
Kelly: Makes sense. And so where do you see wound care management in five years?
Brian: In five years, I would like to see the problem of wound care disappear, that we’re not dealing with wound care the way we do today, which is addressing wounds. I’d like it to become more predictive so that we can intervene before wounds occur. And if we live in a world where there aren’t wounds, does that put Swift out of business? By all means, no. It makes us heroes and champions. And at the outset, I mentioned that Swift Skin and Wound, the first part of the name of our software is skin. And if you think about the aerospace engineers who started their vision looking at the surface of planets, sure, they saw the craters first, the wounds. But there are crevices and there are pebbles and rocks on planets. And there’s a lot of other applicability for our software as we look at ways to enhance the care of the surface of our largest organ, the skin. That could be from dermatology to podiatry and other skin-related issues.
Kelly: It’s a very interesting way of looking at it. So, where or when are most patients most at risk for wounds when in the hospital?
Brian: Patients are at risk for chronic wounds when they are not fully ambulatory. Patients can develop pressure injuries, particularly older patients with comorbidities, relatively quickly, within several hours of being in a hospital bed. And this is a really important issue for hospitals because there’s a tremendous burden on hospitals to detect and diagnose pressure injuries. An assessment of a patient has to be done within 24 hours of admission, whether there’s a pressure injury there or not. Because if there’s not an assessment done during that time and a pressure injury is later discovered, Medicare will hold that hospital responsible for the injury and won’t cover the associated care. So, prompt diagnosis, documentation, and treatment are required. And that’s something that Swift facilitates for hospitals as well.
Kelly: Very good. And so why are chronic wounds the number one risk factor for hospitals?
Brian: I think they’re the number one risk factor for hospitals because in hospitals, patients tend not to move. Even when they’re going from a diagnostic testing facility to the room, they’re usually transported by wheelchair. The longer individuals stay in their beds, stay in their wheelchairs, the more susceptible they are to these wounds. It’s a huge risk for hospitals because hospitals tend to be focused primarily on the acute reason the patient is in the hospital. And often, the skin-related issues are secondary to that. So, they’re not necessarily as immediately focused on wound care and the skin. They’re focused on treating the heart attack or the pneumonia, and they’re not necessarily thinking about the skin and what’s going on under the covers of the hospital bed. So that’s one reason. There are workflow-related challenges in the hospital that make it difficult. There’s also not a lot of clinicians that are trained in how to identify the risks associated with chronic wounds and how to treat chronic wounds. That’s both doctors and nurses. So, the environment that’s been established within the walls of a hospital make the likelihood, the prevalence of wounds high. The ability to identify them and to intervene and reduce them are quite challenging.
Kelly: Yes, it would seem to be. What can hospitals do to manage those risks? And how would that impact costs?
Brian: Hospitals have to make wound care a primary area of focus within all sites of care, acute and post-acute, within the hospital. We’ve already discussed the risks associated to hospitals for not doing that. But by identifying the risk factors for developing chronic wounds, pressure injuries in particular, and putting in place better opportunities to monitor these factors for the patients will lead to better quality wound care programs and the reduction in the associated risks. A single pressure injury can increase a nursing staff’s workload by 50%. But if you put the right tools in place and in the hands of a clinician, with the right diagnostic tools, you can actually increase staff satisfaction, improve patient outcomes, and also enhance the workflow.
Kelly: Outstanding. Well, thank you so much for joining us today, Brian, and for sharing your insights on burden to business driver, revolutionizing wound care through AI-powered technology.
Brian: It’s a pleasure to be here, Kelly. Thank you so much for the opportunity.
Kelly: And if a listener wants to learn more or contact you to discuss this topic further, how best can they do that?
Brian: I’d be happy to have people reach out by email. My email is Brian, B-R-I-A-N, dot Litten, L-I-T-T-E-N, at swiftmedical.com.
Kelly: Thank you so much for providing that for us. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…
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