PAVE Clinics

“Any veteran can get the mat if clinically indicated, no matter their VAMC,” said Suzanne Shirley, LCSW, Director of Partnerships & Community Engagement VHA Innovation Ecosystem. “Their provider can order the mat through the prosthetics service,” which is part of the Prevention of Amputations for Veterans Everywhere clinics present in every medical center.

Obtaining a mat is a little easier in the 15 VAMCs that are already using them and those that have been part of a study on their utility at the Phoenix VA and the VA Greater Los Angeles Healthcare Systems. That study found that the device detected 97% of DFUs as much as five weeks before the onset of systems. It also should a high rate of adoption among veterans; 86% of the high-risk veterans with diabetes issued a mat used it an average of three times per week and, at one center, 84% used in almost daily.1

Starting Dec. 1, field testing of the mats was to begin in six centers in south Georgia and Florida, Robbins said. The PAVE clinic providers will identify patients who could use the mat and then the VA will deliver them as part of a larger study to evaluate how well they work to reduce amputations, Shirley said.

Veterans with diabetes have foot assessments each year. As part of the evaluation, the risk of a foot ulcer is scored 0-3, said Robbins. Those with a risk of 0 or one are reevaluated annually. Those with risk levels of 2 or 3 have ongoing surveillance, with more frequent foot examinations. Factors that increase the risk of ulcer include the presence of peripheral artery disease, neuropathy and end-stage renal disease.

“Mats would be prescribed by a provider for veterans in PAVE Risk 3 category as part of the program,” Shirley added.

“VA’s early adoption of cutting edge, innovative solutions to combat a disease that impacts so many veterans is another example of how VA is aiming to be a leader in healthcare innovation,” said VA Secretary Robert Wilkie. “VA is uniquely positioned in its ability to test and quickly scale new solutions throughout its healthcare system, which can drastically change veteran lives.”

Frykberg RG, Gordon IL, Reyzelman AM, Cazzell SM, Fitzgerald RH, Rothenberg GM, Bloom JD, Petersen BJ, Linders DR, Nouvong A, Najafi B. Feasibility and Efficacy of a Smart Mat Technology to Predict Development of Diabetic Plantar Ulcers. Diabetes Care. 2017 Jul;40(7):973-980. doi: 10.2337/dc16-2294. Epub 2017 May 2