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No Wonder We Need to Turn Off the Tap

No Wonder We Need to Turn Off the Tap

by Caroline Fife, M.D. | Mar 11, 2019 | Fight the Good Fight, Health Information Technology and Wound Care

This is a retired surgeon with venous insufficiency. Whenever his compression garments become old, his leg swelling worsens and an old surgical scar on the lateral leg re-opens. Lymphatic fluid begins draining out of the PERI-WOUND area after a cleaning the area...
Sisyphean Mondays

Sisyphean Mondays

by Caroline Fife, M.D. | Mar 11, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, US Wound Registry

In Greek mythology, Sisyphus was cursed by the gods to spend eternity rolling a boulder up a hill, only to have it roll down again. In the March issue of TWC, I talk about my Sisyphean Mondays with heart failure patients, who represent a quarter of my wound care...
Don’t Miss This – Poison Ivy

Don’t Miss This – Poison Ivy

by Caroline Fife, M.D. | Mar 7, 2019 | Fight the Good Fight, Health Information Technology and Wound Care

Poison Ivy – treated with topical and systemic steroids… and a doctor’s excuse for hiring a yard crew. Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes through quality driven care. Please visit my...
Don’t Miss This – Why I LOVE Garments for Edema in the Over-65 Age Group

Don’t Miss This – Why I LOVE Garments for Edema in the Over-65 Age Group

by Caroline Fife, M.D. | Mar 5, 2019 | Fight the Good Fight, Health Information Technology and Wound Care

Allow my assistant to demonstrate the ease with which they may be applied….so why don’t more people who treat venous patients know about this option? This is not a long term solution for edema. Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician...
Our Dirty Little Secret – Antibiotics Help Heal Some Chronic Wounds

Our Dirty Little Secret – Antibiotics Help Heal Some Chronic Wounds

by Caroline Fife, M.D. | Mar 4, 2019 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program

In 2013 we were winding down the analysis needed to create the Wound Healing Index (WHI), a mathematical model to stratify wounds by their likelihood of healing. The goal was to enable the reporting of honest healing rates. Susan Horn and I have published a lot about...
Strategies for Winning Pressure Ulcer Lawsuits

Strategies for Winning Pressure Ulcer Lawsuits

by Caroline Fife, M.D. | Feb 28, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

Successful Strategies for Winning Pressure Injury Litigation against Health Care Providers Talk about why they should be able to “Get to Zero!” Use the facility’s “Pressure Ulcer Prevention Protocols” against them. Use the NPUAP Staging System – the Plaintiff’s best...
Super Mario – And "Simplexity"

Super Mario – And "Simplexity"

by Caroline Fife, M.D. | Feb 27, 2019 | Healthcare Payment Policy

Mario from New Life Brace and Limb came to the rescue again. He’s working on a device to off-load the spine of a quadriplegic who is going to put my son through graduate school with his pressure ulcer challenges. Every time we fix one problem, it causes another...
Pre-Authorization for All… and Medicare by Any Other Name

Pre-Authorization for All… and Medicare by Any Other Name

by Caroline Fife, M.D. | Feb 25, 2019 | Healthcare Payment Policy

Remember Hyperbaric Prior Authorization which CMS had in effect for 3 states? They didn’t have to extend the program because it was so successful. Here’s a graph of the impact from 2014 to 2016 in which HBOT utilization decreased by 50%, and not just in those 3...
Transdermal Oxygen for the Irradiated Field – I’ll Be Darned if it Didn’t Work!

Transdermal Oxygen for the Irradiated Field – I’ll Be Darned if it Didn’t Work!

by Caroline Fife, M.D. | Feb 21, 2019 | Healthcare Payment Policy

I’ve got a lot of patients who have had very targeted local radiation. Some of them got radiation years ago for really questionable reasons, the others for only recently. The non-healing wounds present in the irradiated field can be small but really persistent. The...
Oh, Was That All You Needed?

Oh, Was That All You Needed?

by Caroline Fife, M.D. | Feb 19, 2019 | Healthcare Payment Policy

This message was left on the voice mail of our Wound Clinic Program Director. I’ve cut out any patient identifiers and the name of the payer. She’s providing a list of the documentation needed for her to authorize hyperbaric oxygen therapy: [regarding patient...
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