by Caroline Fife, M.D. | Oct 7, 2019 | Healthcare Payment Policy, Pressure Cooker: Rethinking Pressure Ulcers
WPS Government Health Administrators (GHA) is a Medicare Administrative Contractor (MAC) and its Local Coverage Determination (LCD) on Wound Care became effective on April 16, 2018. The U.S. states impacted by the WPS LCD on Wound Care are: Jurisdiction 5 (J5) –...
by Caroline Fife, M.D. | Aug 21, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The story of my son’s intraoperative pressure injuries In August of 2017, Hurricane Harvey dumped 52 inches of rain on Houston turning the 4th largest city in America into a literal island. However, with our house above water, I was selfishly focused on...
by Caroline Fife, M.D. | Aug 19, 2019 | Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, The Patient's Voice
Patients inspire me every day. This lady in her 9th decade showed me a picture on her smart phone (which alone is an accomplishment). She’s at church playing the accordion and the piano at the same time. I’ll add her to my gallery of patients with “undaunted spirit.”...
by Caroline Fife, M.D. | Jul 8, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
To paraphrase Bum Phillips, “There’s two kinds of doctors, them that’s been sued and them that’s gonna be sued.” I’ve been sued more than once but they were all “non-suited” except one. When I was on the medical school faculty, the University paid a settlement on my...
by Caroline Fife, M.D. | Jun 12, 2019 | Pressure Cooker: Rethinking Pressure Ulcers
This pressure ulcer formed from the inside out on the right 5th MT head. The lesion evolved over 11 weeks. What do you think this means? If you saw the wound as it is on the photo to the right below, is there any intervention that would have prevented the development...
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...
by Caroline Fife, M.D. | Feb 11, 2019 | Don't Miss This, Pressure Cooker: Rethinking Pressure Ulcers
I recently saw a patient with digital ischemia who got improvement in both pain and tissue viability with transdermal oxygen from the OxyBand dressing. There are a lot of possible reasons for digital ischemia, so it’s important to know why the patient has ischemic...
by Caroline Fife, M.D. | Feb 8, 2019 | Don't Miss This, Pressure Cooker: Rethinking Pressure Ulcers
In 2016, The National Pressure Ulcer Advisory Panel (NPUAP) changed their staging system. I am not talking about changing the term “ulcer” to “injury.” I am talking about changing the definitions of stages 2, 3 and 4. This is a big deal, and...
by Caroline Fife, M.D. | Jan 28, 2019 | Fight the Good Fight, Health Information Technology and Wound Care, Pressure Cooker: Rethinking Pressure Ulcers
Since the pressure ulcer staging system is based on the tissue you can visualize, we get caught up in a bizarre logic. It ought to be possible to describe the steps a wound goes through to get to a stage 4 pressure ulcer. But you can’t, because an ulcer doesn’t become...
by Caroline Fife, M.D. | Aug 14, 2018 | Cassandra Chronicles: Regulatory and Coverage Policy, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
The White House Office of Management and Budget (OMB) spent 6 months reviewing a proposed rule to ease Medicare-participation requirements called, “Regulatory Provisions to Promote Program Efficiency, Transparency and Burden Reduction.” CMS has promised to “reform...
