by Douglas Dirschl, MD
In the fall of 2008, I wrote an article for OrthopaedicList.com about the high prevalence of fragility fractures in the United States, how only 20% of Americans sustaining a fragility fracture received the appropriate evaluation and treatment of their underlying osteoporosis, and how the American Orthopaedic Association had successfully piloted a program called “Own the Bone” to help improve patient care and change physician behaviors related to this issue. Today I write to communicate to you that the AOA’s Own the Bone™ program has been launched nationally and is currently accepting enrollment by hospitals, physicians, and/or communities of practitioners. I encourage you to read on and to visit www.ownthebone.org for additional information.
Own the Bone™ is an evidence-based quality improvement program for patients with fragility fractures. The program endeavors to bring together hospitals, providers, patients and communities around improving the lives of patients with osteoporosis and fragility fractures. Own the Bone™ is designed to prevent future fractures in patients who have sustained fragility fractures by increasing the application of current evidence-based guidelines set forth in the National Osteoporosis Foundation Clinician’s Guide to the Prevention and Treatment of Osteoporosis and highlighted in the 2004 Surgeon General’s Report on Bone Health and Osteoporosis.
The goals of Own the Bone™ are to assist clinicians in identifying, evaluating, diagnosing, and treating patients with poor bone health after a fracture and improving awareness of the fracture risk. In this program, adherence to evidence-based treatment guidelines is measured. Ultimately, Own the Bone™ endeavors to reduce the risk of secondary fragility fractures in participating patients.
Participation in Own the Bone™ makes it easy for physicians and hospitals to do the right thing for these patients. The program facilitates patient education efforts by providing a downloadable library of patient education materials and promotes guideline-based care through the use of computerized reminders based on patient characteristics. The easy-to-use web interface streamlines submission of data and retrieval of educational materials, as well as completion of the easy-to-use electronic case report form. Data submitted to the Own the Bone™ program is used to develop confidential benchmarking reports for sites to evaluate progress and improve systems of care based on evidence-based guidelines. These reports also allow sites to compare their results against the aggregate results of other program participants.
Participating in Own the Bone™ requires the following:
- Enrolling as a site in the program;
- Identifying patients > 50 years of age presenting with a fragility fracture;
- Screening, educating, and treating patients as appropriate;
- Entering patient information into web-based quality improvement registry;
- Following up with patients after 60-90 days via a letter or phone call (this is a recommended, not mandatory, step).
The Own the Bone™ registry constitutes a Limited Data Set under HIPAA requirements. The only elements of potentially identifiable Protected Health Information included are date elements and patient ages, so the program may not require full IRB approval at many institutions.
Subscribers are provided with many benefits. Some of the benefits include:
- Comprehensive start-up materials to help simplify the implementation of the program (available both in hard copy and online through a secure, subscriber-only section);
- Access to a national Web-based registry, with reporting and benchmarking capabilities;
- Best practice library;
- Patient education tools;
- Physician education tools;
- System generated Patient and Physician letters documenting the patient’s risk factors;
- Public relations tools (press release/communication templates and access to a “participating member”);
- Web-based training;
- Ongoing best-practice sharing;
- Electronic newsletters.
The Own the Bone program has been designed to enable a healthcare community – hospitals, orthopaedists, and other physicians and providers – to improve the care of patients in their own backyard. The program can make it very easy to do the right thing for these patients, improve their lives, and reduce their risk of subsequent fractures. I encourage you to refer your hospital administrators, practice partners, and other physicians in your community to the Own the Bone™ website. Additionally, please don’t hesitate to call on me; I will assist you any way I can in convincing your hospital and the physicians in your community that ‘owning the bone’ is in their best interest and that of their patients.
Also, please check out the informational webinar available on the “provider” link at the Own the Bone™ website.
Dr. Douglas R. Dirschl is Frank C. Wilson Distinguished Professor and Chair of Orthopaedics at UNC School of Medicine. He also serves on the Own the Bone Steering Committee and chairs the Critical Issues Committee for the American Orthopaedic Association.