An Inside Look at Intellicure Inc.

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This month, we interview Caroline Fife, MD, FAAFP, CWS, chief medical officer.

  Today’s Wound Clinic (TWC): How long have you been in wound care, and how did you enter this area of healthcare?
  Caroline Fife (CF): I’ve spent nearly a quarter century in the full-time practice of wound care, beginning with my fellowship in undersea and hyperbaric medicine at Duke in 1988.

  While at Duke, I spent time with Claude Burton, who developed the “Duke Boot” for venous leg ulcers. His clinic was the inspiration for the wound center I began at University of Texas Health Science Center in 1990. It was the first wound center in Houston and continues to serve the many institutions within Texas Medical Center.

  When the Medicare guidelines for physician documentation were published, it seemed obvious that the system was so complicated that no doctor could consistently determine the correct level of service for a patient visit. I began working on a computer system to calculate the physician level of service, later joining forces with David Walker, who had already computerized hyperbaric documentation requirements.

  In 1997, the Memorial Hermann Wound Center went “live” online with the first generation of what became Intellicure, making us the first wound center in the US to have an electronic platform. David and I later developed and validated a method for facility billing via “acuity scoring.” The electronic health record (EHR) internally audits the chart based on the nurse’s documentation and calculates the facility charge at the same time it is calculating the physician charge, so clinicians and institutions can be confident their documentation will support the charges they generate.

  TWC: What are your highest-selling products or services?
  CF: Intellicure 5.1. Our certified electronic health record (EHR) is popular because we ensure documentation compliance and medical record security. The ability of Intellicure to internally audit the record and calculate physician- and facility-level of service is a necessity for confident and compliant charge processing. Physicians are more likely to capture their HITECH adoption money since we offer the most options for meaningful use reporting, allowing providers to demonstrate up to 25 core and five menu-set objectives to qualify for incentive payment.

  Once the electronic documents representing the clinical chart are generated, they are locked against subsequent alteration, stored, and secured just as you would have stored and secured paper documents (a requirement according to the Health Information Management Systems Society [HIMSS]).

  LCD (Local Coverage Determination) Defender. This software product ensures expensive procedures, such as bioengineered skin, contain the elements needed for compliant documentation. Our unique internal calculations for debridement automatically select the correct paired codes based on wound size and percent debrided. We also ensure the physician’s and the facility’s documentation for debridement correlate. These unique safeguards protect facilities and physicians from potential repayments due to poor documentation should they undergo an audit by a Recovery Audit Contractor (RAC). The increasing scrutiny of wound centers by RACs is making LCD Defender popular.

  Medical Quality Assurance (MQA). Clinics can contract for medical review of all initial consultations for a defined period of time. MQA fills a need for further wound care training after physicians have completed introductory courses.

  TWC: Describe your day-to-day role.
  CF: When I’m not practicing clinical medicine, I support the ongoing design and development of the Intellicure EHR so that it continues to be the best clinical documentation system. A major focus of my work is the incorporation of clinical practice guidelines to help standardize wound care. I work with our development team to expand our interactive quality-reporting features that allow stakeholders to find missed opportunities for improvement.

  TWC: Why are you passionate about the work of your company?
  CF: In 2005, Intellicure provided the data to CMS officials that demonstrated their proposed plan to reimburse wound centers by wound size would not result in a fair distribution of charges.

  We created, validated, and published an alternative billing structure, which we termed “acuity scoring,” (a measure of staff work) that is now the most common method of wound center billing.

  We are passionate about improving quality of care with our decision-support tools, thus decreasing total cost of care. We can measure patient outcomes with our interactive reports and benchmarking services. Because of its internal charge auditing, Intellicure is the ideal documentation system for future accountable care organizations.

  TWC: How would you describe the overall mission of your company?
  CF: To harness information technology to improve healthcare. This means ensuring patients have the best possible outcomes by making decision support available at the point of care and tracking physician compliance with practice guidelines.


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