by Caroline Fife, M.D. | Sep 1, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Here’s some straight talk on clinical pathways. We’ve all gotten the message on “evidence based” medicine by which payers use data, primarily from randomized controlled trials (RCTs) to decide what treatments they will cover. I’ve had some concerns about that since...
by Caroline Fife, M.D. | Aug 31, 2015 | Cassandra Chronicles: Regulatory and Coverage Policy, Miscellaneous Musings, Pressure Cooker: Rethinking Pressure Ulcers, US Wound Registry
I mentioned a “pay for performance” model that CMS is trying out for Home Health Agencies. Well, an AHRQ study published in the British Medical Journal explored ways in which data were collected and used in Nursing Homes as a result of participation in a...
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 26, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Together with John C. Rasmussen, PhD., Melissa B. Aldrich, PhD., Renie Guilliod, MD, Thomas F. O’Donnell Jr., MD, and Eva M. Sevick-Muraca, PhD., we have published a new paper open access via ScienceDirect. “Near-infrared fluorescence lymphatic imaging in...
by Caroline Fife, M.D. | Aug 19, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Last week I showed you the abnormally low transcutaneous oximetry of a woman after radiation to the axillae with single digit TCOM values. With oxygen breathing, the two really low values improve but not up to normal like the one that is over 200 mmHg. I did an oxygen...
by Caroline Fife, M.D. | Aug 18, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Last week I mentioned ICD-10 so I thought it might be interesting to discuss why using the right “words” in the chart, to get a coder to code correctly for HBOT, is going to be very tricky. I’m going to try to explain this for “late effects of radiation” but it IS...
by Caroline Fife, M.D. | Aug 14, 2015 | Fight the Good Fight, Health Information Technology and Wound Care
Good morning and Happy Friday! Friday’s on the blog are reserved for “Ask the Physician Friday.” If you have any questions for me please feel free to leave them in the comments below, ask on Twitter (@carolinefifemd), or on Facebook (@Woodlands Wound Physicians). I...
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 28, 2015 | Fight the Good Fight, Health Information Technology and Wound Care, US Wound Registry
Every Tuesday this month we’ve been having some straight talk about a US Wound Registry Quality Measure. I’d like to talk about the measure “Appropriate use of hyperbaric oxygen therapy for diabetic foot ulcers”. This was the first HBOT measure the USWR asked CMS to...
