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AOA Own the Bone ® INSERT YOUR SITE NAME HERE. Welcome Goals of Meeting Discuss osteoporosis and low bone density Learn about the AOA Own the Bone ® Program Identify and Initiate Implementation Steps for Own the Bone. Welcome/Goals. 2. Osteoporosis/Low Bone Density Magnitude of Problem.

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Aoa own the bone insert your site name here

AOA Own the Bone®INSERT YOUR SITE NAME HERE


Welcome goals

Welcome

Goals of Meeting

Discuss osteoporosis and low bone density

Learn about the AOA Own the Bone® Program

Identify and Initiate Implementation Steps for Own the Bone

Welcome/Goals

2


Osteoporosis low bone density magnitude of problem

Osteoporosis/Low Bone DensityMagnitude of Problem

3

  • Nearly 25% of patients who suffer a hip fracture die within 12 months, while another 20% end up in a nursing home

  • Fragility is the most common cause of fractures among seniors, yet only 20% of patients receive best-practice care

  • Up to 50% of all women and 25% of all men over age 50 will sustain fragility fractures in their remaining lifetime


Fragility fracture occurrences

Fragility Fracture Occurrences

  • Fractures cost: >$19 billion/year

  • Increase expected if no action

400,000wrist

550,000

vertebral

350,000

hip

125,000

pelvic

675,000

other

Sources: American Cancer Society . Cancer Facts & Figures 2010. Atlanta: American Cancer Society; 2010.

Heart Disease and Stroke Statistics — 2011 Update, American Heart Association.

JOURNAL OF BONE AND MINERAL RESEARCH, Volume 22, Number 3, 2007

Published online on December 4, 2006; doi: 10.1359/JBMR.061113


Why did aoa create own the bone

Why Did AOA Create Own the Bone® ?

5

  • AOA Critical Issue: AOA understood it would take leadership to change physician and patient behavior

  • AOA developed Own the Bone to address a treatment gap highlighted in the 2004 U.S. Surgeon General’s Report on Bone Health and Osteoporosis

  • AOA successfully piloted Own the Bone in 14 hospitals in the United States for 10 months in 2005/2006

  • Results published in JBJS January 2008


What is own the bone

What isOwn the Bone® ?

6

  • A web-based quality improvement initiative

  • Multi-specialty approach

  • A means to identify, evaluate and initiate evidence-based care for osteoporosis and low bone density after a fragility fracture in patients aged 50 and over

  • Follows National Osteoporosis Foundation Clinician’s Guidelines

    • Overlaps with CMS, AMA Physician’s Consortium, HEDIS Measures

    • Consistent with Joint Commission Monograph on Osteoporosis


Own the bone goals

Own the Bone®: Goals

7

  • Increase overall awareness and improve utilization of evidence-based management of osteoporosis and low bone density in fragility fracture patients 50 and over

  • Change physician and patient behavior to reduce the incidence of future fractures and improve patient care by promoting bone health

  • Encourage clinicians to identify, evaluate, diagnose, and treat patients with poor bone health after a fragility fracture

  • Close the “treatment gap” documented in theRAND and NCQA studies

  • Capitalize on the “Teachable Moment”


Own the bone benefits

Own the Bone®: Benefits

8

  • Promotes gathering and recording of pertinent information efficiently through a national, web-based registry

  • Access to a downloadable library of patient education tools to assist in compliance with 10 evidence-based measures

  • System-generated patient and physician letters detailing the patient’s risk factors and recommendations for better bone health

  • Benchmarking reports allows us to compare our results against the aggregate results of all Own the Bone participants

  • E-Newsletters


Own the bone benefits1

Own the Bone® : Benefits

9

  • Web-based training

    • Registry webinar trainings held every other month

    • Registry training videos available at ownthebone.org for subscribers

  • Exchange of best practices among participants through ongoing webinars

  • 40% Discount on National Osteoporosis Foundation patient education materials

  • Public relations tools

    • Press Release templates

    • Special Own the Bone Participant Logo


Aoa own the bone insert your site name here

Why enroll in Own the Bone®?

  • Improve patient care

  • - It’s the right thing to do!

  • Positive public relations

  • - Quality documentation and benchmarking with other facilities

  • - Increase patient volume - “center of bone health excellence”

  • Preparation for Healthcare Reform and future regulatory requirements

  • - CMS, PQRS, Joint Commission

  • Liability concerns

  • - Avoid lawsuits due to “failure to diagnose and treat” after a fracture


The program measures

The Program Measures

Nutrition Counseling*

  • Calcium supplementation

  • Vitamin D supplementation

    Physical Activity Counseling*

  • Weight-bearing and muscle strengthening exercise

  • Fall prevention education

    Lifestyle Counseling*

  • Smoking cessation (if needed)

  • Limiting excessive alcohol intake

    *Unless contraindicated

Measures listed here are consistent with recommendations from the National Osteoporosis Foundation, the Centers for Medicare & Medicaid Services, the Joint Commission, the World Health Organization, and the American Medical Association.


The program measures1

The Program Measures

Diagnostic Testing*

  • Dual Energy X-Ray Absorptiometry (DXA) to test bone mineral density

    Pharmacology*

  • Pharmacology for the treatment of osteoporosis

  • Multiple options

    Communication*

  • Letter and educational material to patient

  • Letter to Primary Care Physician

    *Unless contraindicated

Measures listed here are consistent with recommendations from the National Osteoporosis Foundation, the Centers for Medicare & Medicaid Services, the Joint Commission, the World Health Organization, and the American Medical Association.


Own the bone case report forms

Own the Bone®Case Report Forms

Simple Case Report Forms facilitates data management


Aoa own the bone insert your site name here

Own the Bone®

Web-based Data Registry

14

Simple, Web-based registry facilitates data management

Property of American Orthopaedic Association (AOA)


Implementation

Collect data

Enter and manage the data

Provide patient education materials (downloadable from the registry)

Communicate with Physician and Patient through system-generated letters

Refer or schedule for DXA or pharmacotherapy, when indicated

Follow up at 90 days (optional)

Implementation

15


Implementation questions to consider

Define trigger system to identify patients

Who do we treat?

Hip fracture patients? Other?

Determine protocol to screen and treat patients

Define lab panels

Order osteoporosis consult

Schedule DXA

Assign roles to team members

Who identifies eligible patients?

Who counsels patients?

Who does data entry?

Implementation: Questions to Consider

16


Timeline

Review www.ownthebone.org website and Getting Started/Subscriber’s binder

Define trigger system to identify patients

Determine protocol to screen and treat patients

Assign roles to team members

Set next meeting

Timeline

17


Resources

Resources

  • Getting Started Binder

    Program protocol

    Best practices

    Case Report Form

    National Osteoporosis Foundation – A Reference Guide for Osteoporosis Reimbursement Policy for Healthcare Professionals

  • Visit www.ownthebone.org for more materials

    Training Webinars

    More best practices

  • Contact Own the Bone staff

    Phone: 847-318-7336

    E-mail: [email protected]


Aoa own the bone team

AOA Contact Information:

www.ownthebone.org

[email protected]

Phone: 847.318.7336

Fax: 847.318.7339

AOA Own the Bone® Team

19


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