Podimetrics is a care management company that is looking to eradicate diabetic foot ulcers
Steven Loeb speaks with Dr. Jon Bloom, co-founder and CEO of Podimetrics, a care management company that is looking to eradicate diabetic foot ulcers.
Our goal is to understand how technology is radically changing healthcare: the way we screen, treat and measure progress and outcomes. Whether tech is helping or hurting our well-being physically and mentally. And whether we’re creating productivity that drives economic costs down while improving are overall health.
Highlights from the interview:
- One of the most memorable experiences Bloom had was a patient he encountered as a third year medical student who had a diabetic foot ulcer. When this patient came in, because of the odor coming from that wound, he knew that they were probably going to lose their limb and not make it through the hospitalization. Then, when he was training in anesthesia, he would spend whole days in the operating room doing nothing but amputations, something he compared to Civil War medicine. This devastates the most vulnerable patients: if you're a Black American, your likelihood of suffering an amputation is three times that of a white American.
- If you have diabetes, your lifetime risk of getting a foot ulcer is about one in three. Diabetics have a fairly insensate foot, so they’ve lost their natural alarm system that would typically feel tissue damage. Also, high glucose impedes their ability to fight tissue damage and they often have very bad blood flow, so they can't bring enough mediators and healing cells to that region to actually get good oxygen and good cellular healing. It's like a perfect storm of problems.
- Once a patient has a foot ulcer, their probability of getting another one in 12 months is 40%, and 50% in two years. Their likelihood of hospitalization is twofold for heart attack, stroke, CHF, and COPD exacerbation. It's like a systemic bomb that goes off in your foot in terms of an inflammatory cascade.
- Ulcers are prevalent among veterans, which may be a result of Agent Orange having some effects on the pancreas and their handling of glucose for Vietnam veterns. These are also patients who often have high rates of smoking, and there's a lot of extra mental health challenges. In addition, social determinants of health are very present among veterans.
- The foot is an amazing thing to give us data and there's a lot the company can do to help patients so can remain independent. In addition to ulcers, the foot can also help with determining things like heart failure and other vascular conditions.
- Podimetrics is not a diagnostic; it arms the clinician with the best tools possible so they are aware of what's happening in their patient. It is a medical device, though, and it has FDA clearance. The company had to make sure it was good and accurate at measuring temperature, so it was a lot of data to ensure that it was a useful tool to be used by the clinician.
- The company allows wound care doctors and podiatrists to be aware of how their patients are doing in between visits. The maximum they can see a patient is every 61 days for Medicare guidelines but, ideally, they should bring them in if you need it. Podimetrics allows them to manage their business and cohort much better.
- Bloom believes remote patient monitoring is going in the wrong direction, because you're forcing now doctors to monitor every single patient, which is additional work. He think it should be about managing population at the same time, passively, and that's how to move forward patient care for the provider.
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