Remote Patient Monitoring for Diabetic Peripheral Neuropathy Can Reduce Diabetic Foot Users and Amputations

by | Oct 1, 2020 | Blog

Diabetes is the seventh leading cause of death in the United States [1]. In 2018, there were more than 34.2 million Americans with diabetes, representing 10.5% of the population [2]. Another 88 million have been diagnosed with prediabetes, yet experts suspect the disease is greatly underreported. The impact of diabetes on individuals and their families can be significant. Studies show that one in four individuals living with diabetes will develop foot ulcers (DFUs) at some point in their life, with nearly half reoccurring in the first year. [3],[4] In addition, foot ulcers are a leading cause of amputations with 85% of lower extremity amputations being preceded by a foot ulcer [5]. Life expectancy for patients with even a partial amputation is five years [6].

Providers treat approximately 1.7 million diabetic foot ulcers in the US each year [7]. Patients with DFUs experience 14 outpatient visits and 1.5 hospitalizations annually [8].

The good news is that the International Working Group on the Diabetic Foot reports that up to 85% of all diabetic-related amputations can be prevented [9]. Given this, why is it that every 30 seconds someone loses a lower limb or part of a lower limb to diabetes? [10] According to The Foundation for Peripheral Neuropathy, under-managed diabetic peripheral neuropathy (DPN) is the leading cause of non-traumatic limb amputation [11]. However, it can be nearly impossible for providers to optimally manage DPN without the ability to remotely monitor patient physiologic parameters such as plantar pressure, adherence, and temperature. But that is changing.

Remote patient monitoring for DPN

NavCare, an industry leader in chronic care management services, and Orpyx® Medical Technologies, an innovator of digital health therapeutics, have recently partnered to address the problem of DFUs and amputations. Dr. Breanne Everett, co-founder, president, and CEO of Orpyx, identified the need for a solution when she was completing her medical residency program in plastic and reconstructive surgery. Dr. Everett recognized the alarming number of diabetic patients with reoccurring DFU-related complications. She began working with surgeons, scientists, and engineers to design and develop Orpyx® SI Sensory Insoles. The sensor-embedded insoles allow providers to remotely monitor plantar pressure and temperature. With plantar pressure being a causative factor of ulceration and temperature being a late-stage indicator of inflammation and tissue damage, the Orpyx® SI Sensory Insoles offer a multi-factor approach to measure what matters in preventing DFUs. The solution also monitors patient adherence, which is critical to eliciting positive behavioral changes and alerts the wearer to immediately take action and address areas of high-pressure that may lead to tissue breakdown. The sensory data is uploaded to a cloud-based dashboard where the provider can review physiological data to proactively manage patient care and help make necessary treatment adjustments between office visits.

Patients using Orpyx® SI Sensory Insoles have experienced a significant reduction in DFU recurrence:

  • 86% reduction in ulceration when worn more than 4.5 hours a day
  • 71% reduction in ulceration for all patients

Read about our partnership with Orpyx® SI Sensory Insoles

Financial Benefits

Providers managing 100 patients with DPN per year may realize up to $76,000 in additional net practice revenue by dispensing diabetic shoes and Orpyx® SI Sensory Insoles. CMS allows the outsourcing of chronic care management and remote patient monitoring to third-party vendors. Providers can see greater financial gain by using NavCare’s 24/7 virtual clinician support team. With NavCare, RNs and LPNs can foster adherence and monitor patients based on providers’ care plans and protocols. NavCare can log actions, notes, and time spent with patients into the providers’ EMR/EHR record to ensure accurate, timely reimbursement.

Patients with DFUs cost the US healthcare system twice as much as those with diabetes alone, and lower extremity complications are responsible for as much as one-third of the $176 billion in direct costs of diabetes [12]. Leveraging solutions like the Orpyx® SI Sensory Insoles and remote patient monitoring from NavCare help reduce costs, increase revenue, and significantly improve outcomes. But even more important, this helps patients to live longer, healthier, and more productive lives.

 


[1] https://www.diabetes.org/resources/statistics/statistics-about-diabetes
[2] ibid.
[3] Cavanagh PR, Lipsky BA, Bradbury AW, Botek G. Treatment for diabetic foot ulcers. Lancet 2005; 366(9498): 1725-35
[4] Armstrong, DG, Boulton AJM, Bus SA. Diabetic Foot Ulcers and Their Recurrence. N Engl J Med 2017;376:2367-75
[5] International Working Group on the Diabetic Foot. Diabetes and the foot.
[6] ibid.
[7] Cavanagh PR, Lipsky BA, Bradbury AW, Botek G. Treatment for diabetic foot ulcers. Lancet 2005; 366(9498): 1725-35
[8] Margolis, DJ, Malay, DS, Hoffstad, OJ, et al. Economic burden of diabetic foot ulcers and amputations: data points #3(prepared by the University of Pennsylvania DEcIDE Center, under Contract No. HHSA290200500411). In: Data Points Publication Series
[9] International Working Group on the Diabetic Foot. Diabetes and the foot.
[10] ibid.
[11] https://www.foundationforpn.org/what%20is%20peripheral%20neuropathy/types%20risk%20factors/
[12] https://diabeticfootonline.com/diabetic-foot-facts-and-figures/

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