WoundAIssist: A Patient-Centered Mobile App for AI-Assisted Wound Care With Physicians in the Loop

The rising prevalence of chronic wounds, especially in aging populations, presents a significant healthcare challenge due to prolonged hospitalizations, elevated costs, and reduced patient quality of life. Traditional wound care is resource-intensive, requiring frequent in-person visits that strain both patients and healthcare professionals (HCPs). Therefore, we present WoundAIssist, a patient-centered, AI-driven mobile application designed to support telemedical wound care. WoundAIssist enables patients to regularly document wounds at home via photographs and questionnaires, while physicians remain actively engaged in the care process through remote monitoring and video consultations. A distinguishing feature is an integrated lightweight deep learning model for on-device wound segmentation, which, combined with patient-reported data, enables continuous monitoring of wound healing progression. Developed through an iterative, user-centered process involving both patients and domain experts, WoundAIssist prioritizes an user-friendly design, particularly for elderly patients. A conclusive usability study with patients and dermatologists reported excellent usability, good app quality, and favorable perceptions of the AI-driven wound recognition. Our main contribution is two-fold: (I) the implementation and (II) evaluation of WoundAIssist, an easy-to-use yet comprehensive telehealth solution designed to bridge the gap between patients and HCPs. Additionally, we synthesize design insights for remote patient monitoring apps, derived from over three years of interdisciplinary research, that may inform the development of similar digital health tools across clinical domains.

WoundAmbit: Bridging State-of-the-Art Semantic Segmentation and Real-World Wound Care

Chronic wounds affect a large population, particularly the elderly and diabetic patients, who often exhibit limited mobility and co-existing health conditions. Automated wound monitoring via mobile image capture can reduce in-person physician visits by enabling remote tracking of wound size. Semantic segmentation is key to this process, yet wound segmentation remains underrepresented in medical imaging research. To address this, we benchmark state-of-the-art deep learning models from general-purpose vision, medical imaging, and top methods from public wound challenges. For fair comparison, we standardize training, data augmentation, and evaluation, conducting cross-validationto minimize partitioning bias. We also assess real-world deployment aspects, including generalization to an out-of-distribution wound dataset, computational efficiency, and interpretability. Additionally, we propose a reference object-based approach to convert AI-generated masks into clinically relevant wound size estimates, and evaluate this, along with mask quality, for the best models based on physician assessments. Overall, the transformer-based TransNeXt showed the highest levels of generalizability. Despite variations in inference times, all models processed at least one image per second on the CPU, which is deemed adequate for the intended application. Interpretability analysis typically revealed prominent activations in wound regions, emphasizing focus on clinically relevant features. Expert evaluation showed high mask approval for all analyzed models, with VWFormer and ConvNeXtS backbone performing the best. Size retrieval accuracy was similar across models, and predictions closely matched expert annotations. Finally, we demonstrate how our AI-driven wound size estimation framework, WoundAmbit, can be integrated into a custom telehealth system. Our code will be made available on GitHub upon publication.