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Abstract Number: 2720

Providing Comprehensive, Comparative Post-TJR Outcome Feedback To Surgeons For Quality Monitoring and Value Decisions

Patricia D. Franklin1, Bruce Barton2, Leslie R. Harrold3, Wenjun Li1, Regis O'Keefe4, Jeroan Allison2 and David Ayers1, 1Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, MA, 2Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, 3University of Massachusetts Medical School, Worcester, MA, 4University of Rochester Medical Center, Rochester, NY

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Osteoarthritis, outcome measures and total joint replacement

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Session Information

Title: Clinical Practice/Patient Care

Session Type: Abstract Submissions (ARHP)

Background/Purpose: With the CMS decision to publicly report hospital-specific post-operative total joint replacement (TJR) events and readmissions, surgeons and hospitals need comprehensive post-hospital data by which to manage and monitor outcomes. Currently, hospitals lack complete data on post-discharge events because patients seek care at multiple emergency rooms and hospitals. In addition, more than 40% of US TJR patients are under 65 years of age and are not captured in CMS data. To address this data void, we developed methods to capture comprehensive post-TJR medical and surgical events, as well as longitudinal patient-reported outcomes, and to report comparative data to participating surgeons and sites.

Methods: We established a national consortium of >120 diverse orthopedists representing all regions of the US with varied hospital and surgeon practices to ensure that data reflect typical US practice. We are enrolling >10,000 patients annually. Web-based and scannable paper data collection formats support efficient data gathering. Patients consent to participate and submit annual outcome assessments directly to us to assure complete reporting of hospital and emergency care. Post-TJR medical events are validated through chart review and CMS data (for those >65 years). Quarterly post-operative event rates and PROs are calculated for the national cohort, the individual surgeon, and site to deliver comparative feedback.

Results: A secure, HIPAA compliant MD website was established that presents summary and comparative descriptive statistics for primary TKR and THR for all of enrolled patients, specific to the site, and to the surgeon. A secure downloadable and printable report includes an Executive Summary of key outcome comparisons, as well as comprehensive tables of patient demographics, pre-operative medical and musculoskeletal comorbidities, post-operative events, and post-operative PROs enabling the providers to compare their outcomes to the other participating surgeons. Patient-level data are provided on request by the surgeon

Conclusion: In an era of public reporting of outcomes, surgeons and hospitals need a single comprehensive source of post-discharge medical events, readmissions, and PROs to manage and monitor all patient outcomes. We developed a secure web-site to return comparative data to providers. These data are used to demonstrate value in payer negotiations and to guide quality improvement efforts.


Disclosure:

P. D. Franklin,

NIAMS-NIH, NLM-NIH, AHRQ, Zimmer, ,

2;

B. Barton,
None;

L. R. Harrold,

CORRONA, Inc.,

5;

W. Li,

AHRQ,

2;

R. O’Keefe,
None;

J. Allison,

AHRQ,

2;

D. Ayers,

AHRQ, Zimmer,

2.

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