by Caroline Fife, M.D. | Nov 29, 2018 | Fight the Good Fight, Health Information Technology and Wound Care
Every time someone gives one of those “how wounds heal” lectures, it starts with “the first phase of wound healing is hemostasis,” and we think to ourselves, “Yeah, yeah, everybody knows that part . . .” Lately I’ve been paying more attention to the issue of...
by Caroline Fife, M.D. | Nov 28, 2018 | Fight the Good Fight, Health Information Technology and Wound Care
Earlier this week I was showing a patient that, while his wound might look like it was still open, in fact, most of it was covered with skin. When the epithelial cells first migrate, they are translucent and you have to get the light at an angle to determine whether...
by Caroline Fife, M.D. | Nov 26, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
Since I’ve been left to figure out this quality thing for wound care pretty much on my own, I’ve had a lot of ups and downs. One of my goals (but not the only one) is to develop quality measures to help practitioners and patients survive the increasing pressure of...
by Caroline Fife, M.D. | Nov 21, 2018 | Fight the Good Fight, Health Information Technology and Wound Care
By way of explanation, when we first made the transition to ICD-10, there was an article about the 16 most absurd codes and my daughter had already been in the emergency room with one of them (W55.41XA: Bitten by pig, initial encounter). So, yesterday, when she...
by Caroline Fife, M.D. | Nov 20, 2018 | Fight the Good Fight, Health Information Technology and Wound Care
The USPSTF just released its 8th Annual Report to Congress: High-Priority Evidence Gaps for Clinical Preventive Services, in which screening for peripheral arterial disease with the Ankle Brachial Index (ABI) is listed as one of the areas in need of better data before...
by Caroline Fife, M.D. | Nov 19, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
“Million Hearts,” which launched in 2012, is a national initiative by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS). Its 5-year aim was to prevent a million acute cardiovascular events by improving...
by Caroline Fife, M.D. | Nov 16, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program
The Alliance of Wound Care Stakeholders has alerted its member organizations to a “policy article” just released by the Medicare Administrative Carrier (MAC) Noridian limiting coverage of Cellular and/or Tissue Based Products (CTPs) to the treatment of Venous Leg...
by Caroline Fife, M.D. | Nov 15, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Lymphatic Imaging & Lymphedema
This is an 80 year old man with severe bilateral lower extremity lymphedema. I hospitalized him the day I took these photos. He had copious amounts of neon green drainage and increasing erythema of his legs, but what really precipitated hospital admission was his...
by Caroline Fife, M.D. | Nov 13, 2018 | Fight the Good Fight, Health Information Technology and Wound Care
This patient is in is 50’s (younger than I am). He has hypertension, liver cirrhosis, type 2 diabetes, and sleep apnea (he’s a chair sleeper). He’s still obese 3 years after a gastric sleeve operation. He’s chronically fluid overloaded with pitting edema to his groin....
by Caroline Fife, M.D. | Nov 12, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Lymphatic Imaging & Lymphedema
I’ve been thinking a lot about lymphedema due to venous disease vs. other types of lymphedema. I think the differences are worth pondering. We see the impact of venous disease so often that it is a bit like living in a war zone – after a while the abnormal becomes...