Fife CE, Eckert KA, Carter MJ, et al.
Advances in wound care. Date of publication 2018 Mar 1;volume 7(3):77-94.
1. Adv Wound Care (New Rochelle). 2018 Mar 1;7(3):77-94. doi:
10.1089/wound.2017.0743.
Publicly Reported Wound Healing Rates: The Fantasy and the Reality.
Fife CE(1)(2), Eckert KA(3), Carter MJ(3).
Author information:
(1)Department of Geriatrics, Baylor College of Medicine, Houston, Texas.
(2)The U.S. Wound Registry, The Woodlands, Texas.
(3)Strategic Solutions, Inc., Cody, Wyoming.
Significance: We compare real-world data from the U.S. Wound Registry (USWR) with
randomized controlled trials and publicly reported wound outcomes and develop
criteria for honest reporting of wound outcomes, a requirement of the new Quality
Payment Program (QPP). Recent Advances: Because no method has existed by which
wounds could be stratified according to their likelihood of healing among
real-world patients, practitioners have reported fantastically high healing
rates. The USWR has developed several risk-stratified wound healing quality
measures for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) as part of
its Qualified Clinical Data Registry (QCDR). This allows practitioners to report
DFU and VLU healing rates in comparison to the likelihood of whether the wound
would have healed. Critical Issues: Under the new QPP, practitioners must report
at least one practice-relevant outcome measure, and it must be risk adjusted so
that clinicians caring for the sickest patients do not appear to have worse
outcomes than their peers. The Wound Healing Index is a validated
risk-stratification method that can predict whether a DFU or VLU will heal,
leveling the playing field for outcome reporting and removing the need to
artificially inflate healing rates. Wound care practitioners can report the USWR
DFU and VLU risk-stratified outcome measure to satisfy the quality reporting
requirements of the QPP. Future Directions: Per the requirements of the QPP, the
USWR will begin publicly reporting of risk-stratified healing rates once quality
measure data have met the reporting standards of the Centers for Medicare and
Medicaid Services. Some basic rules for data censoring are proposed for public
reporting of healing rates, and others are needed, which should be decided by
consensus among the wound care community.
DOI: 10.1089/wound.2017.0743
PMCID: PMC5833884
PMID: 29644145
