1. Mobilizing Data for Pressure Ulcer Prevention Challenge:
Solution by RAImax Healthcare Solutions Group, LLC
1. Increase the number of “Wound Free Days” in a Nursing Facility Environment
2. Utilize Android Tablets at the bedside to computerize the Assessment process with
customizable workflow from Admission to Discharge
3. Store Assessment Electronic Data centrally and make available to anyone with the appropriate
credentials and access to the network
4. Build Reports, Dashboards and Analysis tools to make it easier to monitor compliance and
analyze trends in results
5. Give Facilities the ability to build their own Risk and Wound documentation assessments with
customizable triggers and alerts
1. Most Nursing Facility Assessment processes utilize paper forms which include assessments for
Risk, Weekly Skin, Weekly Wound and Non-Ulcer Weekly Skin Condition. Access to
assessments is limited to individuals in the facility and there is a potential for assessments to
be misplaced
2. Results from Assessments are usually recorded in spreadsheets creating the possibility for data
transcription errors or omissions in results
3. Compliance with Assessment completion is time consuming and difficult
4. Skill set of treatment nurse may not be sufficient to treat a specific wound or a wound is either
not healing or getting worse with no change in treatment
Problems:
Goals:

2. Approaches:
1. Develop a set of application design requirements based upon input from subject matter
experts including multiple WOCNs, RNs with experience in Long Term Care
2. Build a customizable, workflow enabled application that utilizes an Android Tablet for
documenting at the point of care.
3. Pilot the application in a group of Nursing Facilities
4. Review pilot results and make the appropriate changes to the application prior to go live
5. Go live in multiple nursing facilities
Outcomes:
1. One Size does not fit all so having the ability to customize the workflow around each
facility’s schedule was very important
2. Very positive response from the Treatment Nurses and Nursing leadership. The tablet was
easy to use and saved staff time
3. Having the assessments scheduled by the system led to fewer missed assessments and the
use of the dashboard increased compliance with the overall assessment process
4. Storing the assessments in a centralized database where they are accessible to anyone
with the appropriate credentials for any location on the network has eliminated the
possibility of misplacing an assessment and has streamlined the QA/Survey process by
third party consultants.

3. Innovations and Key Features:
1. One of the first Android Tablet applications written for the Long Term Care Community
2. User Defined Assessment Wizard which allows the user to implement their own Risk
Assessments with customized triggers and alerts
3. Custom Android Camera Control with our “Photo Assist” feature providing a transparent image
of the previous wound photo allowing the user to adjust distance and alignment in order to take
consistent photos.
4. Wound Tracing and surface area calculation of wound characteristics. Gives you a more accurate
surface area measurement of items such as Wound Bed, Necrotic Tissue and Granulation.
5. Multi-Facility and Centralized database with no data or images ever stored on the tablet
computer. The tablet utilizes WCF messaging to Send and Receive data . Supports the use of a
standard VPN connection in order to be used from a remote site that may only have an internet
connection
6. Ability to review previous assessments from the tablet
7. Windows PC interface in addition to the tablet which allows both individuals to review and
complete assessments from a laptop or desktop computer. Supports the ability to start an
assessment on the tablet and complete the assessment from a Windows computer
8. Dashboards to monitor compliance, review trends with specific wound items and run reports
with customizable criteria
9. Generate HL7 formatted message from WCF web service for Pressure Ulcer Assessments

4. Integration:
The Android tablet application utilizes a Web server with WCF services in order to communicate
with the centralized SQL server. In the following example, the WCF service “GetPressureUlcerData”
has been modified to also produce an HL7 message. Assessment components can be mapped to
LOINC and SNOMED codes for the development of the message.
WCF (Windows Communication Foundation) is a messaging framework developed by Microsoft
intended to allow data to be sent no matter what type of platform the client is running.
In addition to creating an HL7 message, the WCF services can also be modified to integrate directly
into other SQL databases as well as query data from other databases.
HL7 Sample Message produced from GetPressureUlcerData Service:

5. Screenshot Examples:
Care/Alert Dashboard for Monitoring Braden Assessment created by Assessment Wizard
Skin Record Dashboard to review trends Assessment Wizard Setup Screen