Tidelands Health

Alex Catalano has been working in the wound care industry since five years and he has been at Tidelands for nine months. In this role, Alex Catalano oversees the health system’s wound care services, including two outpatient locations—Tidelands Health Wound Healing Center at Georgetown and Tidelands Health Wound Healing Center at Murrells Inlet. He looks after the day to day operations and also how they can improve efficiency, become more cost effective, and improve their healing measures.

So wound care itself is interesting. It seemed like it was on the side of everyone; there were a lot of surgeons who were doing it as a retirement job or plastic surgeons or general surgeons doing it maybe a half day clinic a week and not truly dedicated wound care providers. But it’s become a lot more prominent issue in healthcare recently, especially with the baby boomer generation getting older and having all these vascular ulcers and diabetic complications which is a majority of what we see.

How has the wound care space changed lately?

 With this global pandemic at the beginning at our wound centers, we cut back greatly because our patient population has the highest risk factors for negative COVID outcomes. But what we found after a few weeks, was that our patients were going to be either seen by us or they’re going to be in the emergency room being seen anyway. Because their wounds were getting worse; so we had a short little dip there in volumes. But they kicked right back up and we’re as busy as we’ve ever been right now.

“When it comes to wound care, the one thing that was taught to me when I first got into wound care at UPMC, was not to get wrapped up in all of the smoke and mirrors and the shiny new gadgets”

How COVID-19 is changing Wound Care?

 It definitely does jumpstart our use of telemedicine. A lot of our patients are pressure injury patients from nursing homes and with the nursing homes being locked down now; they can’t come out to us for fear of contracting COVID and bringing it back to the nursing home. Our hospital has been proactive in other areas when it comes to telemedicine.

"When it comes to wound care, the one thing that was taught to me when I first got into wound care at UPMC, was not to get wrapped up in all of the smoke and mirrors and the shiny new gadgets"

Also a lot of the private insurers are cutting back on their restrictions for payment for telemedicine which is good. Wound care can be a little tough because so much of what we do is hands on, we’re doing a lot of debris movements, a lot of raps, and you can’t do that over the phone. So we’ve partnered well with some of our home health agencies in the area to if you’re going out there, can we do a telemedicine visit while you’re there? So they can at least get the nursing aspect of it. And we can at least get a get a look at it to see if it’s progressing or getting worse or do we need to bring them in.

Could you talk about your approach to identify the right partnership/ solutions provider from the lot?

We referred a lot to one home health company in particular, and because they’ve been a great partners to work with. They follow through on promises when they say they’re going to be out on certain days, they’re there and they give us updates and they’re quick responses. If there’s a form or something we need signed they’re quick to get it to us and talk through everything with us. And they’re always asking to collaborate more when it came to questions with these COVID positive patients they were the ones that contacted us. They wanted to get their leadership on the phone with us and run through what their protocols are and see if they’re up to our standards and help us in any way that we need.

What would be the single piece of advice that you could impart to your colleagues to excel in this space?

When it comes to wound care one thing that was taught to me when I first got into wound care at UPMC was not to get wrapped up in all of the smoke and mirrors and the shiny new gadgets. Rather focus on good protocols and quality wound care and if something new comes out that can help improve healing rates in enclosure quickness. To take it with a grain of salt and do your research and ensure it is what’s best for everyone. Especially one of our products is a big and wound care or these biologically engineered skin substitutes. And there are 90 something on the market now and they’re all made from different types of human tissues, or bovine and cadaver tissues.

They’re coming out all the time and of course everyone’s personal research says that it’s the greatest thing that’s ever come out. And they’re one of the most expensive products in wound care right now. And you could easily find yourself going belly up or going bankrupt using all these products and not focusing on the whole body aspect of it. People have wounds for a reason it could be poor nutrition or poor blood flow. A lot of times trying to slap on a $2,000 skin substitutes is not going to work and then if it does work a lot of times it’ll come back because they still don’t have good blood flow or they not controlling their diabetes.

What’s Next?

In the next 12 to 18 months one thing that CMS has been pushing hard is bundled payments for wound care and that scares all of us in the industry a lot. I personally commented on these proposed rules several times mostly because for some of these bundled payments such as hips and knees you have a lot of control over the situation. But it’s tough with diabetic complications and vascular complications that have so many other factors that go into why these wounds won’t heal. I think that scares a lot of people in the industry and it would also hinder our ability to use some of these advanced products or procedures that we do to close things up.