Here we go again! Hyperbaric Oxygen is one of the most effective therapies I have seen for preventing amputations, reducing healing times, and helping patients drastically improve their quality of life.  And as often happens, it gets stuffed into three familiar headings: Diving, Autisim, and Sports! This brief mention on Hyperbaric Chambers from WIRED Magazine, (by the way, great picture) highlights the ongoing lack of education regarding the proven benefits of Hyperbaric Medicine. Is it not “smart”, that people can actually keep their limbs? I have seen similiar stories over my time in this industry, most notably the myth of  Michael Jackson sleeping in a chamber.

I am glad that WIRED put in a mention of Hyperbaric Chambers, I hope more stories emerge of how beneficial and cost-effective this therapy is for medically accepted, Medicare approved indications.

Hyperbaric Oxygen Therapy is carried out in a Hyperbaric Chamber, not a glorified sleeping bag with a zipper.

The latter was initially developed for mountain climbers to recover from altitude sickness, however now it seems to be standard equipment for every baseball and football player you hear about.

The former must be a A PVHO (Pressure Vessel Human Occupancy) approved chamber, and  has several regulations it must meet. It is a drug-delivery device, since it does deliver Oxygen under pressure to the patient. UHMS (Undersea Hyperbaric Medical Society) and the American College of Hyperbaric Medicine are great resources to learn more about this medical therapy. There are several manufactures that make these clinical chambers here in the US. One of the biggest, and our choice for chambers, is  Sechrist, located in CA.

I cringe each time I hear about a “bag” being referred to as a Hyperbaric Chamber.

I could scream from my soap box about this for hours, however bottom line, the true effects of Hyperbaric Therapy  change lives, and should be under the supervision of trained Physicians, using regulated and safe equipment.

Now you can climb back into your bag.

I was asked the other day to blog about my background and how I got involved in wound care. This is my attempt at describing the fantastic ride I have been on for the last eighteen years.
When I founded Wound Care Advantage in 2002, I had come from several unique experiences in our industry. I had worked as a commercial diver medic in the gulf of Mexico and off the West Coast. It was an amazing experience that gave me some great stories, (and a few less teeth) It didn’t take long to find out that I was a much better medic than I was a diver.

I jumped at the chance in 1994 to build a clinical hyperbaric center in Culver City California. My father was suffering from cancer at the time and I had become enraged at the lack of respect that he often encountered as he went from surgery to surgery. I looked forward to treating patients differently.

The day we opened that center and treated our first wound patient (all I can tell you is that maggots were involved, and not the purchased kind) I knew that this was what I would be doing in one form or another for the rest of my life. We could treat each patient with dignity and compassion, and they got dramatically better.

In 1996 three partners and myself opened Beverly Hills Hyperbarics. This was my first ownership experience, and it too, changed my life. After several years and a great deal of success, I felt the urge to get back into Wound Care. Going from Beverly Hills treating celebrities and post-surgical patients to the San Fernando Valley treating the worst of the worst wounds, was quite a change of pace, and it made feel as though I had found my purpose again.

In the middle of all of this I found an amazing woman to put up with me ( I am still learning Macedonian) we got married and settled down in a small town close to Pasadena called Sierra Madre, which is where Wound Care Advantage is based so I can walk to the office. We have two fantastic boys and I enjoy being a dad more than anything I have ever done.

In my spare Time I joined the Sierra Madre Volunteer Fire Department, and the funny thing is that I think fighting fires prepared me better for running my own company than anything else I could have done!

In 2002, I started what was then “Healing Services Consulting” (Now you know why we changed it to Wound Care Advantage) to focus on what I saw as a void in our industry; A management company intent on being considered the best partner possible, affordable, and focused on small community hospitals that had largely been ignored by many of the bigger companies. I avoided investors so that the company would remain dedicated to the mission.

We opened Lancaster Community Hospital Wound Care Advantage in 2002,  and had a great time building the program. The team became a family, and that is exactly the environment we have diligently tried to recreate in each new center we start. If there is a mistake to make in our industry, I have made it, possibly twice. However, over the next few years I was fortunate to have a team work with me that also saw my vision and were a lot smarter than me.

We developed e-wound and incorporated the coolest tool ever; HIPPA Compliant video-telemedicine program, into our operations.

We kept tweaking our models with the help of Hospital CEO’s and CFO’s that we were already working with allowing hospitals to choose the package that best meets their needs.

Through all of this we have grown into a national company with centers in eight states, and more on the way. We continue to value our status as a “best partner” above all else.

I am looking forward to what comes next, however to date, it’s been one heck of a ride!

Over eighty-million people were born between 1946 and 1964. This translates into the largest number of seniors ever experienced in the United States. These seniors are also experiencing the highest levels of Diabetes, Vascular Disease, Obesity and wounds ever seen in our history.

Over the next two decades these baby-boomers will put an unprecedented strain on Social Security and Medicare.In the mid 1940’s, 42 workers supported each retiree. Today, that ratio is down to only three workers per retiree, and when the boomers have all retired, it will shrink to one. Because of rising medical costs, Medicare is in the worst position. The hospital insurance portion of that program is already dipping into its shrinking reserves.With these issues on the way, and an uncertain plan for Healthcare reform, it is even more imperative than ever before, that hospitals carefully manage every dollar.

A profitable out-patient program like Wound Care and Hyperbaric Medicine will only see it’s demand increase with this aging population and the high prevalence of Diabetes. However, retaining the revenue generated will become paramount. The Wound Care Advantage team has been keenly aware of this dynamic and developed our e-wound and WCA program specifically with these demographic changes in mind. A Wound program can help lower your Length of Stay, assist in minimizing “Never-Events” as related to wounds, manage patients with several co-morbidities in an out-patient environment, and bring in much needed revenue to hospital quickly and consistently.

By providing the lowest cost solution for our partners, we provide them the Advantage of being prepared for the coming storm.

When you close your eyes and try to imagine health care of the future, what does it look like?
For me the answer to that question was always a Jestons like TV screen where a doctor would immediately speak with me face to face, solve my problem, and have my medicine sent to me without ever having to leave my house. What can I say? I watched a lot of cartoons as a kid.

So when WCA set out to implement a medical communication sytem between all of our centers, that Jetsons like system was our goal. After two years we had an exceptiional tele-presence system to work with. It operated only on on Mac Computers initially, now it works on PC’s, and ran over standard internet connections. It is HIPPA compliant and connects every member of our team across the country together for instant face-to-face discussions.

We rolled the system out to each member of our corporate team first. It allowed us to share blue-prints, marketing materials, and reports immediatly with our entire team at one time, then save the video meeting for future review. Once we became more comfortable with the system, we substantially reduced our use of phones for team communications.
When we introduced the system to our physicians in each center, things really got interesting. Physicians used the system to consult with each other and show wounds in real time giving each patient the benefit of two heads instead of one.

We have now rolled this system into Skilled Nursing Facilities (SNF) with a new model focused on dealing with a very difficult population of patients.

No plans for robots serving us or food in pill form, but I think we got at least on piece of the Jetsons right!

Over the past few weeks I have been reading a book entitled; “The Innovators Prescription: A Disruptive Solution for HealthCare by Clayton M. Christensen, and I can’t help but feel that the solution the authors advocate is almost a direct description of out-patient Wound Care Programs. The book outlines a disruptive approach that allows patients with specific health disorders to be treated by a comprehensive team focused on one “problem set”, outside of the expensive confines of acute hospital space.

This group would be streamlined by having team members to facilitate each task, and must be able to share experience quickly to assist in immediate medical problem solving. Patient care will improve as this group comes to develop “precision medicine”, and costs will decline as an expensive therapy in the hands of only highly trained experts can be transfered to a wider population of health care providers using new technology and training. An arcane practice will essentially become the standard of care over time.

Wound Care fits this description perfectly; when I first started in this industry 15 years ago, we were ecstatic if a patient healed a non-healing wound in 65 days. Currently Wound Care Advantage is seeing an average of only 40 days to heal a wound. Amputations are being avoided by the thousands, and the cost of treating these patients has been dramatically reduced by keeping them out of the expensive venue of acute care.
Medicare, the primary payor for Wound Care due to the patient demographics, sees a dramatic cost savings utilizing out-patient wound care programs versus the sporatic and spread out approach used in the past. A typical course of treatment will cost $1,500 to $2,000 dollars for a wound versus hundreds of thousands of dollars over a lifetime for the care and surgery involved in an amputation. Not to mention that most patients like to keep their body parts.

WCA has been on the track of reducing the cost of this therapy for the past several years by putting all of the information our administrative and medical team members have developed online in our e-wound system. We have also developed a video-based telemedicine system which allows instant collaboration with medical teams across the country to help heal a patient faster. We have introduced models that significantly reduces the cost of providing these services.

As Congress and the American population rattle down the road to Healthcare Reform, I hope this model that our industry has developed becomes a center-point in discussions to deliver better care at a lower cost. That would be real Health Care Reform.

Mike Comer, CEO