moorLDI2-BI blood flow
imager for burn wound
assessment
Implementing NICE guidance
March 2011
NICE medical technology guidance 2
What this presentation covers
Background
Guidance
Costs and savings
Discussion
Accessing the guidance and
implementation tools
All images in this presentation
reproduced with kind permission of
Moor Instruments Ltd.
Background:
medical technologies guidance
NICE medical technology guidance addresses specific
technologies notified to NICE by manufacturers.
If the case for adopting the technology is supported, then
the technology has been found to offer advantages to
patients and the NHS.
The specific recommendations on individual technologies
are not intended to limit use of other relevant
technologies that may offer similar advantages.
Background:
current clinical practice
• Assessment of burn wound depth and healing potential
is fundamental in planning burn wound management
• It is difficult to distinguish superficial dermal wounds
from deep dermal burns. It is also difficult to assess
burn wound depth on a child or someone with dark skin,
or when the injury is complicated by oedema, tissue
hypoxia or burn wound conversion
• Clinical evaluation based on visual and tactile
assessment is the most widely used method of
assessing burns. Accuracy is dependent on
the experience of the clinician
Background: moorLDI2-BI
• Laser doppler blood flow imaging system for noninvasive mapping of blood flow in burnt skin
• Can be used in addition to clinical evaluation to decide
whether to treat with surgery
• There is no direct contact with the burn
• Scans take 80 seconds to 5 minutes depending on size
of burn
• Results are displayed as a colour-coded blood flow
image
• Healing potential results are reported as less than
14 days, 14–21 days or more than 21 days
Guidance (1)
The case for adopting the moorLDI2-BI in the NHS is
supported when it is used to guide treatment decisions for
patients in whom there is uncertainty about the depth and
healing potential of burn wounds that have been assessed
by experienced clinicians.
Guidance (2)
There is evidence of benefit for
patients and the NHS when
moorLDI2-BI is used in
addition to clinical evaluation
compared with clinical
evaluation alone, in burn
wounds of intermediate
(indeterminate) depth.
The moorLDI2-BI enables
decisions about surgery to be
made earlier, and for some, for
surgery to be avoided
Left - Blood flow: Right – colour video
MTG2: moorLDI2-BI
National costing summary
Table 1:
Net cost of implementation for England
(population 51.2 million)
Current annual cost of staff, administration and
moorLDI-BI devices
Future expected annual cost of staff,
administration and moorLDI-BI devices
Increased cost of service provision
Expected recurrent
cost/-saving
(£000s)
380.5
1,212.7
832.2
Expected saving due to reductions in hospital
length of stay
-7,129.1
Total annual cost/-saving for the NHS
-6,296.9
Costs & savings for
commissioners
Table 2:
Recurrent annual cost for commissioners per
average population served by each burn care
service (2.44 million people)
(£000s)
Total current costs per year
1,822.1
Total expected costs following implementation
Total annual cost/-saving
1,690.0
-132.10
Provider costs & savings:
annual system costs
Table 3:Costs per average population served by
each burn care service (2.44 million people)
Current annual system costs
Predicted annual system costs when the guidance
is implemented and 100% of burn care services
have a device and current service contract
Incremental annual device costs when the
guidance is implemented
(£)
8,738
18,350
9,612
Provider costs & savings:
annual staff & administration
costs and length-of-stay savings
Table 4:Costs per average population
served by each burn care service
(2.44 million people)
(£)
Current annual staff and administration costs
9,380
Predicted annual staff and administration costs
when the guidance is implemented and 100%
of eligible patients will be scanned
39,396
Incremental annual staff and administration
costs when the guidance is implemented
30,016
When the guidance has been implemented the national total
length-of-stay saving for provider organisations is £7.1m,
around £339k per burns care service on average.
Discussion
Burn Care Services
1. What can we do to check the software and service
contract are up to date?
Clinicians
2. How can we prepare a case for the organisation to
invest in this technology?
3. How can we encourage our colleagues to use this
technology?
Management
4. What needs to be done to facilitate the purchase of the
moorLDI2-BI device in our organisation?
5. What can we do to facilitate implementation of
the device within our organisation?
Accessing the guidance
and implementation tools online
• Guidance
• Costing tools
• Podcasts
Child age one year, Day 2 post hot
drink scald
available from:
www.nice.org.uk/MTG2
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