Cath Lab Digest

DOT WEIR, RN, CWON, CWS:

Dot Weir, RN, CWON, CWS, and CoEditor of Today’s Wound Clinic discusses her journey in wound care, the first SAWC, her passion for her work, Today’s Wound Clinic’s role in the industry and upcoming issues of the journal.

Reflecting back on my 31 years as a nurse, I am in awe of the opportunities that have come my way, many through hard work but some by just being in the right place at the right time and knowing the right people.The most pivotal was a fall day in 1979. My Nursing Director asked if anyone wanted to attend a 3-day ostomy school taught by a wonderful nurse, Anita Kotheimer. Attending this seminar set the stage for my involvement in a richly rewarding specialty where I have learned something new each and every day.

Over the years, I have worked in acute care, long-term care, and home care. I spent 7 years in industry where I learned about the business of health care and traveled the country meeting wound healing thought leaders and researchers — teachers and providers of evidence, respectively. Then my soulmate and colleague Karen Durigan gave me the opportunity to manage an outpatient center — responsibilities that have brought the kind of fulfillment that will carry me until retirement. Five years later, I was helping a hospital in Kissimmee, Fla open an outpatient wound clinic. Now a year after arriving, my clinic partner Dr.Walter Conlan and I are practicing in a hospital system with all of the right ingredients: supportive administration, an outstanding and growing group of nurses from different specialties, a skilled physical therapist, and a supportive, “patients first” front office duo.

Why outpatient practice? Outpatient care demands multidimensional, multidisciplinary approaches.To the patients, we are not only nurses, therapists, and physicians, but also case managers, social workers, and friends. In many cases we become part of the family.We enable people struggling with painful wounds for a short time or for years to see hope in the face of the pain and uncertainty.We save limbs, restore lives, proliferate dignity. We become the go-between with physicians.We are patient advocates,healing not only tissues,but also spirits.

Many clinicians in outpatient care feel they are practicing in a vacuum.They need to reach out to and learn from others who share similar practice, reimbursement, and patient concerns.This is the goal of Today’s Wound Clinic.Whether your practice is individually run or part of a management group.

CAROLINE FIFE, MD;

CHIEF MEDICAL OFFICER OF INTELLICURE, INC.

Caroline Fife, MD, FAAFP, CWS, and CoEditor of Today’s Wound Clinic discusses her start at SAWC, industry commitments, the importance of networking at SAWC, the clinical and practical advantages of the meeting and more.

The truth about my career as a wound expert bears uncanny resemblance to the story of an infamous inorganic chemistry professor. His discovery of an important synthetic material was a complete accident (a la “Flubber”), with the brilliant flashes of insight added later.

In 1990, after a fellowship in Undersea and Hyperbaric Medicine,I was hired as the Director of the Hyperbaric Medicine Unit at the University of Texas Health Science Center, Houston. I knew a great deal about hyperbaric medicine but little about chronic wounds. As the patient referrals began, I knew many did not need hyperbaric oxygen therapy. But what did they need? When I explained to my Chairman that someone needed to open a wound center,he said,“That would be you.”

With no textbooks, no courses, no management companies, no consultants, and few dressings, a wound care center was opened. While completing my fellowship at Duke, I had spent time (truth be told, 2 days) with leg ulcer specialist Dr. Claude Burton. We used his four-page handout, “How to manage venous stasis ulcers” (it featured the concomitant use of the Unna’s boot and DuoDERM (ConvaTec, a Bristol-Myers Squibb Company, Princeton, NJ), known as “The Duke boot” as a template to open our wound center. Soon we were changing 15 Unna’s boots before lunch (with a healing rate of 85%, I might add). In the largest medical center in the world, in the fourth largest city in the US, we were the only “wound center.” Our volume attracted pharmaceutical companies, affording us the opportunity to do clinical trials for many well-known products and devices.

Not long after, a diabetic foot clinic, a lymphedema clinic, and other services were added — usually, with my reluctant approval because I would need to attend yet another meeting outside of my comfort zone to improve my familiarity with additional wound care techniques. I am proud to say that after 17 years, the Memorial Hermann Center for Hyperbaric Medicine and Wound Care is one of the premier programs in the US. I would like to say it was all due to my incredible foresight, but now you know the truth. It is often said that the definition of intelligence is the ability to learn from experience. If that is true, the definition of wisdom is the ability to learn from the experience of others. We hope that is what this journal will do for you — allow you to learn from the experience of others to gain knowledge the easy way.Think of it as experience in your pocket.

ADDITIONAL FOUNDING EDITORIAL BOARD MEMBERS

KATHLEEN D. SCHAUM, MS

Kathleen is the president of her own consulting company, Kathleen D. Schaum & Associates, Inc. In that role, she consults with new and established hospital-owned outpatient wound care departments, physicians, podiatrists, nurse practitioners, wound care nurses, and physical therapists regarding the “business side of wound management”.

Kathleen has also 1) guided the reimbursement strategies for more than 20 wound care manufacturers, 2) applied and received HCPCS codes for more than 200 wound care products, 3) applied and received 6 brand new HCPCS codes, categories, and payment rates for all forms of collagen dressings, and 4) applied and received 1 new HCPCS code for a dermal substitute.

Kathleen is also the Director of Medical Device Reimbursement for Healthpoint, Ltd.

In both capacities, Kathleen brings more than 40 years of reimbursement knowledge and experience to the wound care industry. Kathleen continually monitors reimbursement legislation and regulations, and attends many reimbursement meetings and seminars, in order to maintain her own knowledge regarding this ever-changing topic. She then assimilates that knowledge for her various clients and audiences. Kathleen speaks on the topic of wound care reimbursement at numerous national, regional, and local symposiums and seminars. Her reimbursement publications have exceeded the 100 mark! In addition to creating the new In Business column in Today’s Wound Clinic, Kathleen is celebrating her 8th anniversary of authoring a regular Payment Strategies column in Advances in Skin & Wound Care. She has also guest authored for The Remington Report, Home Health Care Nurse, and Ostomy Wound Management.

Kathleen received her BS degree from Indiana University of Pennsylvania (Indiana, PA) and her MS degree from The Ohio State University (Columbus, OH). She is a registered dietitian of the American Dietetic Association. Kathleen supports the wound care industry through her memberships in The Association for the Advancement of Wound Care, the Wound Healing Society, and the American Professional Wound Care Association.

Kathleen enjoys helping wound care providers and manufacturers improve their business. She says that mastering the coding, coverage, and payment issues surrounding wound care would be quite boring if it weren’t for the people she assists.

VALERIE SULLIVAN, PT, MS, CWS

Val Sullivan is a physical therapist and a board Certified Wound Specialist through the American Academy of Wound Management. She is the Clinical Manager of Advanced Wound Care Services and Hyperbaric Medicine at Capital Regional Medical Center in Tallahassee, FL. A clinician and educator in Wound Management for the past 14 years, Val has lectured and presented on local, regional and national levels as well as publishing articles on wound care and education.

As a member of the American Physical Therapy Association (APTA) and its Section on Clinical Electrophysiology and Wound Management, Val is on the Consulting Group for the Integumentary section of Hooked on Evidence. She has been an active member of the Association for the Advancement of Wound Care, serving on the Quality of Care Task Force. She is also a member of multiple Clinical Advisory Boards and has served on planning committees for regional Wound Care Conferences.
An unabashed oenophile, Val co-founded the Wound Care Wine Club to assist Wound Care professionals in the North Florida/South Georgia area with networking, education and marketing.

CHRISTOPHER A. MORRISON, MD, FACHM, CWS

Dr. Chris Morrison has devoted his full-time medical practice to the specialty of wound care in the St. Petersburg/Tampa Bay area. He serves as Wound Care and Hyperbaric Medicine physician, as well as Medical Director, at numerous local hospitals.

Dr. Morrison received his BS degree from Indiana University (Bloomington, IN) and his MD degree from Indiana University School of Medicine (Indianapolis, IN).

He is a graduate of the Bayfront Medical Center Family Practice Residency program, where he served as Chief Resident. Dr. Morrison then went on to complete the Fellowship program at Bayfront’s Center for Sports Medicine.

A nationally recognized speaker and educator on the subjects of wound care and hyperbaric medicine, Dr. Morrison is triple board-certified: Diplomate, American Board of Family Practice; Diplomate, American Board of Preventive Medicine, Subspecialty Undersea and Hyperbaric Medicine; and Diplomate (UHM), American Academy of Wound Management, Certified Wound Specialist (CWS). In addition, Dr. Morrison has been designated a Fellow of the American Professional Wound Care Association.

He is a member of numerous medical organizations and serves on several professional panels dedicated to the development and furtherance of the subspecialty of wound care.

Dr. Morrison is President and Founder of Nautilus Health Care Group, a leader in wound center management, hyperbaric medicine, wound care and dermatology community outreach services, and health care provider education and training.

EDITORIAL BOARD MEMBERS

DESMOND BELL, DPM, CWS, FACCWS, FAPWCA

Desmond Bell is the CEO of First Coast Diabetic Foot and Wound Management Center and Wound Care on Wheels, Jacksonville, Florida.  He is also the founder and director of Wound Summit Outreach, Inc., the Southeastern Interactive Wound Summit, the Wound Care Consortium of Jacksonville and the “Save a Leg, Save a Life” Foundation. Dr. Bell may be reached at drbell@wounddr.com or at drbell@savealegsavealife.com.

MARY A. NAMETKA, BSN, AAWM, WOCN, MSN, CNS

Mary A. Nametka, a BSN graduate of ‘76 from Binghamton University, earned an MSN in ‘89 from the same school in Family/Community Health Nursing with a minor focus in Administration. In the same year, Mary became Board Certified as a Clinical Nurse Specialist and has practiced in a wide variety of settings including inpatient, long term, psychiatric and Home care. While on active duty in the Air Force, she was introduced to wound care as a specialty and implemented this role as part of her CNS duties in the early 90’s. This practice grew into a full time commitment leading to Board certifications in wound care through both AAWM and WOCN, and development of one of the first nurse run independent wound care clinics in Wisconsin. After relocating to Oregon in 2000, Mary has been working at the Portland VA, and developed an outpatient wound care clinic within the Portland VA Primary Care Division. In 2007 Mary completed requirements to become licensed and certified as a Family Nurse Practitioner and recently accepted a position at the Seattle VA where she will be supporting development of an integrated wound/skin care program. An advocate of continuing education, research and practice, Mary has developed a number of poster presentations, is a requested speaker on the topic of wound care. Education of patients, providers and health care decision makers regarding the holistic paradigm of prevention and care, is in her view, one of our most promising avenues for research and improvement in the way we go about caring for those suffering with chronic wounds. Nametka can be reached at nametka.mary@gmail.com.

ANDREW J. APPLEWHITE, MD, CWS, UHM

Dr. Applewhite grew up in Texas and graduated from Plano Senior High School. He received his undergraduate degree in Psychology from the University of Texas at Austin in 1991. He attended the University of Texas Medical School in Houston where he received his doctorate of medicine in July of 1996 and went on to complete his Family Medicine residency at the University of Texas Medical Branch at Conroe in July 1999. This is where Dr. Applewhite became interested in wounds and HBO working with Dr. Robert Wariner.

After residency, Dr. Applewhite moved to Chicago to practice Family Medicine in the northwest suburbs. He became involved in the local community by serving as the team physician for three area high school football teams and teaching prenatal classes to expectant parents.

In 2003, Dr. Applewhite returned to Dallas where he devoted my full-time practice to the specialty of Wound Care and Hyperbaric Medicine and was named Medical Director and helped launch the Wound Care and Hyperbaric Center at Methodist Hospital of Dallas. Dr. Applewhite accepted the position of Medical Director for the Baylor University Medical Center’s Comprehensive Wound Care and Hyperbaric Center in Dallas, TX on November 19, 2008. He have lectured nationwide and internationally on Hyperbaric Oxygen Therapy and Comprehensive Wound Care. He has continued his involvement in the local community by conducting lectures and educational events for students and fellow medical practitioners.

Dr. Applewhite is a diplomate of the American Academy of Family Physicians, a diplomate of the American Academy of Wound Management, and a Certified Wound Specialist. He is board-certified by the American Board of Preventive Medicine with a subspecialty in Undersea and Hyperbaric Medical Society. Dr. Applewhite can be contacted via email at Andrew.applewhite@BaylorHealth.com.

HARRIET JONES, MD, BSN

Harriet Jones, MD is a 1998 graduate of the University of Mississippi School of Medicine. She completed an Internal Medicine residency and Infectious Diseases fellowship at the University of MS Hospitals and Clinics. Prior to becoming a physician she had been a registered nurse (1985, BSN; University of Southern Mississippi) in surgery and orthopedics primarily. After completion of her medical training, she joined the Infectious Diseases faculty as an Assistant Professor and started the Outpatient Antimicrobial Service and began her concentration on treating post operative infections and chronic wounds. In 2005, Dr. Jones entered private practice as a full time wound care provider. She is board certified in Internal Medicine and holds memberships in the American College of Physicians, WHS, & APWCA. Her email address is doctorhatmd@bellsouth.net.

TRISHA CARLSON, MSN, MBA-HCM, RN, CWCN

Trisha Carlson is the Director of Clinical Quality and Education for National Healing Corporation. Trisha is a past Today’s Wound Clinic author. She is available for questions at tcarlson@nationalhealing.com.

PAMELA G. UNGER, PT, CWS

Pamela G. Unger is presently the Vice President of Post Market Research and Reimbursement at Celleration, Inc. and owner of Unger Physical Therapy (consultation for wound management and reimbursement). She can be reached with questions or consultations via her email address at ungerpt@aol.com or punger@celleration.com.

MOIRA HAYES, MHA, RRT, CHT

Moira Hayes, is the President and CEO of Innovations Healthcare Consulting, Inc. of Houston, Tex. Hayes founded the outpatient wound care and hyperbaric medicine management company. Hayes also held former positions with National Medical Solutions, Inc., National Healing Corporation, Columbia HCA, and the Texas Children’s Hospital. She can be reached with questions or consultations via her email address at moira.hayes@sbcglobal.net.

SUSIE SEAMAN, NP, MSN, CWOCN

Susie Seaman is a Board-Certified Family Nurse Practitioner and a Wound, Ostomy, and Continence Nurse. Ms. Seaman completed her MSN at San Diego State University and her Family Nurse Practitioner training at University of California at San Diego. She has been a CWOCN for 18 years and practiced in the home health care arena for the first eight years before moving to the outpatient clinic setting ten years ago. Ms. Seaman founded the Sharp Grossmont Hospital Wound Healing Center in La Mesa, California in 1998, which at one point was the busiest wound clinic in San Diego County. She left there in 2006 to open a wound clinic for Sharp Rees-Stealy, which is a 450 physician multi-specialty medical group with offices throughout San Diego. She has a special interest in the treatment of lower extremity ulcers and the diagnosis and treatment of atypical wounds. Susie can be reached at susie.seaman@sharp.com.

TERE SIGLER, PT, CWS, CLT-LANA

Tere has worked as a Physical Therapist for 25 years in a range of settings including acute care, outpatient, long term care and home health. She has been focused on wound care since 1991. In 1999 Tere established the Archbold Center for Wound Management at Archbold Memorial Hospital in Thomasville GA and is still the clinical director. This past year the center has expanded to include Hyperbaric Medicine.

Tere is an active member of APTA and AAWC. She earned her CWS through AAWM in 2000. She has served on advisory boards and participated in focus groups for several companies in the wound care industries.

Tere also began lymphedema management in 1996 after completing training in Manual Lymph Drainage through the Vodder School in Walschee Austria. In 2002 she passed the Board Exam to become Certified as a Lymphedema Therapist through the Lymphology Association of North America.

LEAH AMIR, MS, MHA, MHA

Leah Amir, MS, MHA has designed, monitored, and managed clinical trials to achieve FDA approval and reimbursement since 1990 first with Mallinckrodt Medical, then as the Executive Director of The Institute for Quality Resource Management. She achieved FDA approval for a new pap screening device, guided the FDA approval of devices in cardiology, orthopedics, and surgery. As consultant to company CEOs and CFOs she has designed and conducted clinical and economic studies resulting in Medicare and national payment for FocalSeal a surgical sealant for lungs, Embospheres used in Uterine Artery Embolization, Optiray, Octreoscan, and in tandem with Kevin Bostic, MD and the AAOS achieved new codes to improve payment for revision hip and knee surgery. In support of the launch of a new product she presented to the company Board of Directors, developed a strategic plan to aid marketing and sales while providing insight into second generation products. Since 2005 Leah has published on the importance of outcome measures and the need to improve the practice of wound care worldwide by applying scientific rigor to clinical trials to measure the effects of wound care treatments. As a Scientific Advisor to Med Tech Transfer, a Boston based company, she identified new technology and developed processes to achieve proof of concept in record time to prepare the product for FDA approval. Her expertise in process improvement has led to the successful integration of new products into patient treatment protocols while generating a positive ROI for medical manufacturers and healthcare providers.

DONNA CARTWRIGHT, MPA, RHIA, CCS, RAC

Donna is currently the Senior Director of Reimbursement Services at Integra LifeSciences Corporation in Plainsboro, NJ. Donna has a Bachelor of Science Degree in Health Records Administration form York College of Pennsylvania and holds a Master’s Degree in Public Administration with a Health Services Administration concentration from Kean College of New Jersey. Donna is a Registered Health Information Administrator and Certified Coding Specialist with the American Health Information Management Association (AHIMA). She also obtained her Regulatory Affairs Certification (RAC) in 2001 and has worked in Integra’s Regulatory Affairs Department.

Prior to her career at Integra, Donna held Health Information Management roles including Director of Health Information Management, Director for two healthcare consulting firms, and many coding management positions. She was a founding member of AHIMA’s Society for Clinical Coding, and has been a Past President and Distinguished Member of New Jersey’s Health Information Management Association. Donna is an active member of the Association for the Advancement of Wound Care as well as the American Burn Association.

In these various roles, Donna brings 27 years of healthcare coding and reimbursement experience to the industry. She has given numerous presentations on coding and reimbursement issues over the years, and has successfully applied for and received new ICD-9-CM Diagnosis and Procedure codes, CPT codes and HCPCS codes.