Digital, Diagnostic, and Data-First

Mr. Nelson is the VP Sales & Marketing for Swift Medical and Founder of the WoundCareFund & Below the Knee.

• Digital documentation is now essential for audit-proof, consistent wound assessment and compliance with CMS, LCD, and WISeR reimbursement standards.
• Diagnostic-first tools like spectral imaging reduce guesswork, improve staging accuracy, and support real-time clinical decision-making across care settings.
• Data-driven care models enable targeted resource allocation, distinguish hard-to-heal wounds, and support value-based strategies—even in independent practices.
• Skin substitutes, though highly reimbursed, face pricing pressure—necessitating data-supported justification and cost-conscious clinical deployment.
• Integration of digital, diagnostic, and data systems empowers proactive care, enhances provider accountability, and aligns with outcome-based reimbursement trends.

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

It's all I'm hearing everywhere I go, whether I'm at a home health meeting, whether I'm at a mobile wound provider, a hospital-based acuity setting for wounds. Everywhere I go, I'm hearing “digital AI documentation.” 

So, you know, I think it kind of fills in that, kind of the tone, which is driven by a couple of things. So, if we break it down, digital first, you know. Really, to me, what it translates is if you’re still, for example, using eyeballing paper rulers, kind of good luck. Right? The variability, the lack of consistency, the exposure to questions of, you know, what are you seeing? Especially if you've got multiple providers, the variability within and across. So that's, you know, one example where, look at the LCD tightening, look at WISeR reimbursement, look at reimbursement cuts, where, you know, CMS, you know, really in their policies come out and talk about documentation, documentation, documentation. So I think, you know, if you are, you know, providers are being forced to provide, to provide value, to prove value, document precisely, and defend every claim, right? If you're going through a UPIC audit or you're going through an audit, they're not necessarily questioning what you did. They're asking for the why you did it, and that justification is there. So digital workflows, my opinion, are really no longer nice to have, is kind of the price of admission. 

If we look at diagnostic first, so we talk about digital moving to the diagnostic. So diagnostic, again, the money is shifting from technologies that reduce guesswork. So it really comes down to, again, that “why.” Why are we doing? How do you prove that you did that? If you said it was a 2 sq cm or a 3 sq cm wound, was at 1.5 x 2? How did you do that? But are you also looking at the depth? So is it a volume? Is it a wound area reduction? Are you calling it stalled, but in actuality, you're building a granulation base? So I think being able to really chart and talk about these things, digital tools are going to give you that consistent ability across providers, regardless of this, you know, are you in your office? Are you in a wound care center? Are you in a mobile van? Are you in the patient's living room? So where are you as you're capturing this information? But that's the diagnostic, right? So it's reducing the guess work. So spectral imaging, for example, is really going to also help you as you're staging your patient. So am I seeing a thermal variance? It may mean there's an infection if it's an exposed wound. It may mean that the patient wasn't offloading with the bony prominence and a wound might be developing. So can we take a look at things? So can I, again, capture information to begin preventing issues as a point of care as opposed to waiting for them and I'm, you know, triaging the care with that. But, again, we’re in that world of payers saying, “Show me why,” and so that’s where I think the diagnostics encompassing the digital is really that new backbone of wound care decision making.

Skin subs are, they remain the topic du jour. You know, it’s a relatively small percentage of what the overall patient continuum is, it's a high reimbursed model. So it definitely is what we're talking about again. But, you know, these, they're being repriced. So prices are coming down, you know, and accounts are really needing to kind of reassess how they provide care. Not that they don't provide care, but how they provide care, because they've got to manage their businesses a little bit differently as a result of some of the economic changes. And so I think the data first really helps them show healing trajectories, utilization patterns. So I look at the data first is, you know, with, you know, we all wear a couple of hats in our lives these days, right? Whether it's a technology like Swift where you can really have a data portal in the back end, you know, I think providers should be looking at kind of that value-based care approach. Value-based care generally has been resigned to, oh, you're a big IDN, you're Kaiser, your Blue Cross. Well, if I take that value-based care approach to an independent provider practice, that data gives you the opportunity to really manage your patient care with the resources that are needed. So if I can see where the true stalled wounds are, if I can see which patients are really the hard-to-heal versus the ones that are going to kind of heal on their own trajectory, then I can allocate my resources, ie, different care providers or different levels of care to where they need to be. So it gives you a chance to, along the line of digital, right, capture the information, manage the ecosystem, diagnostics, provide the care where I need to. In a data first, I'm capturing the data, but I'm using it to better my providing. And at the end of the day, managing my resources, managing my business. So that's kind of how I see digital diagnostic and data first is just, you know, the industry is in a phase where reimbursement rewards insight more than volume in some instances. So it's really about capturing as much information as you can.