New Digital Innovation Initiative Aims to Reduce Amputations

Announced at last week’s New Cardiovascular Horizons (NCVH) Annual Conference, a new digital innovation initiative is now open to all members of the American Podiatric Medical Association (APMA); involves use of CarePICS, a software application for wound management and vascular care coordination.

In the United States alone, a leg is amputated every two minutes. As announced at the New Cardiovascular Horizons (NCVH) Annual Conference, this confronting statistic is being met head on by a digital innovation initiative referred to as SL2 for “Saving Limbs. Savings Lives.” Enrollment in SL is now open to all members of the American Podiatric Medical Association (APMA), the country’s largest non-profit organization dedicated to advancing the practice of foot and ankle medicine.

APMA members will have access to CarePICS, a software application purpose built to support best practices in wound care, including electronic consults and electronic referrals for optimal collaboration with peers in the vascular community. As an added benefit, many of the activities facilitated within CarePICS are eligible for reimbursement. The application may be used via mobile phones, desktop computers and iPads/tablets. It does not require any special devices.

The nationwide launch of SL2 is considered Phase 2 of the digital innovation initiative, with Phase 1 having drawn to a close at the end of May 2023, following a successful six-month pilot in Florida and Texas. Phase 2 will run for 12 months, through June 2023, at which time the potential for a permanent program will be evaluated.

The steadily increasing rate of lower extremity amputations in the United States – an estimated 60% deemed preventable – is shown to be the result of four key variables: (1) imprecise wound assessment and measurement (using manual tools), (2) inadequate and inconsistent wound documentation, (3) suboptimal patient follow-up and communication, and (4) fragmented coordination between providers who encounter wounds, such as podiatrists, and vascular specialists who treat associated medical conditions, mainly peripheral arterial disease (PAD) and critical limb ischemia (CLI). SL2 is positioned to combat these variables through a combination of digital tools, educational courses, data analysis and member support.

“When we look broadly at the medical histories of patients who have undergone lower extremity amputations, the evidence reveals that only about half have ever had a vascular evaluation or were referred to a vascular specialist. Their condition simply progressed to a stage where the limb could not be salvaged,” says Dr. Timothy Yates of Palm Vascular Centers, who participated in Phase 1 of SL2. “This is exactly the scenario SL2 is helping avoid. Using the CarePICS app, podiatrists can quickly and easily request an electronic consult with a vascular specialist, then convert it to an electronic referral when it’s indicated that the patient needs a vascular evaluation.”

“The CarePICS app has been a game changer for our wound care practice,” says Dr. Eric Lullove of West Boca Center for Wound Care, who also participated in Phase 1 of SL2. “Not only can we achieve precision and efficiency in our wound measurement and documentation, our patients can message with us, they can upload images, even participate in televisits. It is also possible to order wound dressings and cellular tissue products through the app.”

SL2 is governed by an advisory panel of physicians with expertise in podiatric and vascular medicine (in alphabetical order):

  • David B. Alper, DPM
    Member of Board of Trustees, American Podiatric Medical Association
    Board Member, American Diabetes Association – Northeast Region
  • M. Laiq Raja, MD, FACC, FSCAI
    Director and Co-Founder, Pulse Amputation Prevention Centers
    Interventional Cardiologist and Limb Salvage Specialist, El Paso Cardiology Associates, P.A.
    Medical Director of Cardiology and Critical Limb Ischemia Program, The Hospitals of Providence Memorial Campus

The SL2 advisory panel is directed by Christopher K. Bromley, DPM, FACFAS, Chief Medical Officer of CarePICS and Adjunct Professor at Kent State University College of Podiatric Medicine.