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 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. | 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...
by Caroline Fife, M.D. | Jul 23, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
They say the ancient Egyptians used honey as a dressing. Interesting that we came back around to it as an industry only to have CMS decide NOT to cover it. Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes...
by Caroline Fife, M.D. | Jul 16, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Remember when the only advanced dressing we had was Duoderm? I still love that stuff. It is still one of the best debriding agents there is. I take Duoderm paste (not gel but PASTE) and cover it with a Duoderm pad and in about 3 days the autolytic debridement is...
by Caroline Fife, M.D. | Jul 13, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
Last week I asked how things were going with getting eCQMs into your EHR. You need to do this to avoid negative payment adjustments but also because your performance on quality measures may very likely be the way that payers decide WHETHER they will send patients to...
by Caroline Fife, M.D. | Jul 9, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
There are a lot of wonderful cleansers out there but some of my patients can’t afford them. This is the recipe that I give them to make a 0.25% acetic acid solution if they have the classic neon green drainage of Pseudomonas: 3 Tbsp white vinegar in 1 quart distilled...
