Design and development of an mHealth application for pressure ulcer care and caregiver support

Smartphone accessibility has enabled the widespread use of mobile health applications for managing health conditions. While mobile technology is increasingly adopted globally, integrated digital solutions specifically supporting home-based pressure ulcer care remain limited. This study aimed to design and develop a mobile health (mHealth) application named IPI (Interprofessional Pressure Injury) application that integrates artificial intelligence-based pressure ulcer staging, caregiver-focused education, personalized nutritional support, and visual wound monitoring to assist caregivers and healthcare professionals in delivering timely and effective care.

A comprehensive deep learning framework was developed using a clinically validated dataset of pressure ulcer images spanning six categories, including healthy tissue and Stage 1-4 ulcers. To address class imbalance and subtle inter-class variability, a class-adaptive augmentation pipeline and an enhanced Vision Transformer architecture with hierarchical feature representation and specialized self-attention were implemented. Training employed a stratified 5-fold cross-validation, class-balanced focal loss, regularization techniques, and a two-tiered ensemble strategy.

The proposed k-fold ensemble model achieved an accuracy of 0.9705 and macro F1 score of 0.9695, with perfect classification of Stage 4 ulcers and substantial improvements for underrepresented classes.

These results demonstrate the model's effectiveness for pressure ulcer classification, offering a robust foundation for real-time clinical decision support. The application supports remote monitoring, healing status detection, and educational access, especially in resource-limited settings. This holistic solution not only enhances caregiver confidence and independence but also aids clinicians in wound assessment and intervention planning. A future experimental study will validate the app's clinical utility, impact on patient outcomes, and potential to improve the quality of home-based pressure ulcer management.