by Caroline Fife, M.D. | Aug 27, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Here are 2 binders full of nursing notes on a patient with a pressure ulcer. I spent about 6 hours trying to find an entry that was different from the ones “auto-populated” day after day after day for weeks. In other words, the previous days observations were just...
by Caroline Fife, M.D. | Aug 24, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
In July, CMS announced a proposed new model of funding for home healthcare that will affect the delivery of wound care provided by home nursing. The model, included in the CY 2016 Home Health Prospective Payment System proposed rule, updates payments and requirements...
by Caroline Fife, M.D. | Aug 20, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Health Information Technology and Wound Care, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Here’s a note from a hospital EHR. The nurse has typed into the record so it’s legible, but you can’t use the data for anything because there’s no place to put or retrieve measurements or wound products and no place to put photos. This is what is happening in most...
by Caroline Fife, M.D. | Aug 17, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I’ve previously posted information about the way that Congress got out of the annual “Doc Fix” problem with new legislation that restructures physician payment based on a variety of quality programs. Recently, Medicare trustees have warned that by 2048 physician pay...
by Caroline Fife, M.D. | Aug 13, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Here is a note from a doctor I worked with for years who is one of the best clinicians I ever had the privilege to practice with. I hope they won’t read this blog and ever find out that I used one of their notes as an example of a fabulous doctor with illegible...
by Caroline Fife, M.D. | Aug 10, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, Quality Payment Program, US Wound Registry
I have big news. The Undersea and Hyperbaric Medical Society (UHMS) has partnered with the US Wound Registry (USWR) to sponsor The Hyperbaric Oxygen Therapy Registry (HBOTR). Submitting data to this registry will satisfy the requirement of a specialty registry...
by Caroline Fife, M.D. | Aug 6, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I have been thinking a lot about whether we have or haven’t improved how we keep patient health records. Here’s a record from the 1800’s when the primary purpose of the record was to remind the doctor what the patient had complained about and what he had done about...
by Caroline Fife, M.D. | Aug 3, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, Quality Payment Program, US Wound Registry
I have previously blogged about big changes that could affect the delivery of hyperbaric oxygen therapy services. I’m keeping my eye on a House Ways & Means health subcommittee (chaired by Kevin Brady from my own district). A few days ago, the subcommittee...
by Caroline Fife, M.D. | Jul 30, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
This is one of my patients who developed an abscess and wound dehiscence following an ankle reconstruction. We were worried that he might be developing osteomyelitis. He works at a plant and uses an infrared thermometer to check for hotspots in the mechanical...
by Caroline Fife, M.D. | Jul 27, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last month, the Centers for Medicare and Medicaid Services made public more hospital and physician billing data. The 2013 data covers about 950,000 providers who received $90 billion in Medicare payments. Medicare’s highest physician payments went to hematologists and...
