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Cassandra on MIPS Year Two

Cassandra on MIPS Year Two

by Caroline Fife, M.D. | Jan 22, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program

It’s Year Two. I can’t decide if that conjures up the image of primitive man making the second straight line on the wall of the cave, or Captain Kirk dictating into the ship’s log… probably the latter. It’s the second year of the Quality Payment Program (QPP)...
To MIPS or not to MIPS? That is the Question.

To MIPS or not to MIPS? That is the Question.

by Caroline Fife, M.D. | Jan 17, 2018 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program

It’s time for a new acronym. You might not have heard of an organization called MedPAC, the Medicare Payment Advisory Commission. MedPAC has a lot of influence and no power. Or maybe it’s the other way around. It is an independent US federal body...
More on the Effectiveness of the Flu Vaccine

More on the Effectiveness of the Flu Vaccine

by Caroline Fife, M.D. | Jan 12, 2018 | Fight the Good Fight, Health Information Technology and Wound Care

Driving into work today I caught the NPR story with Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. I had no idea that the effectiveness of the flu vaccine varies so much from year to year! Some years it is nearly zero and...
Are We Headed for a Flu Epidemic?

Are We Headed for a Flu Epidemic?

by Caroline Fife, M.D. | Jan 8, 2018 | Fight the Good Fight, Health Information Technology and Wound Care

Like every hospital, everyone in my clinic received the flu vaccine. Despite this, 30% of my staff became ill with the flu (confirmed via testing) which is unprecedented in my memory. According to the CBS Evening News, flu cases nationwide are “up sharply,” based on...
In case you missed it in 2017: A Taxonomy For Skin Disorders in Lymphedema Patients

In case you missed it in 2017: A Taxonomy For Skin Disorders in Lymphedema Patients

by Caroline Fife, M.D. | Dec 29, 2017 | Fight the Good Fight, Health Information Technology and Wound Care, Lymphatic Imaging & Lymphedema

I thought I would wind up 2017 with something that I hope will be a useful tool in 2018. Dr. Jane Armor at the Sinclair School of Nursing, University of Missouri spearheaded the American Lymphedema Framework Project (ALFP). The goal was a systematic review of all the...
Pressure Ulcer Summit

Pressure Ulcer Summit

by Caroline Fife, M.D. | Dec 15, 2017 | Fight the Good Fight, Health Information Technology and Wound Care, Quality Payment Program

It has taken a decade. In 2008 I put together a program called “Pressure Ulcers and the Law” which I patterned after the programs on birth injuries and the law that changed the way cerebral palsy cases were handled. It was demonstrated that most cases of CP happen...
At Last, the FDA Guidance We Needed Regarding Clinical Decision Support Inside EHRs

At Last, the FDA Guidance We Needed Regarding Clinical Decision Support Inside EHRs

by Caroline Fife, M.D. | Dec 11, 2017 | Fight the Good Fight, Health Information Technology and Wound Care

On Thursday, Dec. 7th 2017, the FDA issued draft guidance explaining which clinical decision support (CDS) tools won’t be considered devices (and thus will NOT require FDA clearance). This is part of the homework that the FDA needed to do to adhere to the...
Don't Miss This: Vasculitis

Don't Miss This: Vasculitis

by Caroline Fife, M.D. | Dec 8, 2017 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care

The photo above is a pretty classic case of vasculitis, with palpable purpura, and these lesions HURT. The patient is a young healthy school teacher and we never found the cause. This is a leukocytoclastic vasculitis, too. This patient, who has a lot of medical...
Don't Miss This: Atrophie Blanche

Don't Miss This: Atrophie Blanche

by Caroline Fife, M.D. | Nov 29, 2017 | Don't Miss This, Fight the Good Fight, Health Information Technology and Wound Care

This is atrophie blanche. Note the smooth ivory white plaque of skin with telangiectasias. It has other names, including lividoid vasculopathy. These areas often ulcerate. It is NOT vasculitis. It is usually excruciatingly painful. The majority of these lesions are...
Time for Transparent Standards in Quality Reporting

Time for Transparent Standards in Quality Reporting

by Caroline Fife, M.D. | Nov 27, 2017 | Fight the Good Fight, Health Information Technology and Wound Care

A recent issue of JAMA contained a Viewpoint article by Pronovost and colleagues about the need for transparent standards in quality reporting by healthcare organizations:. I communicated with Pronovost to thank him for raising this issue. I’ve been troubled about...
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