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AOA Own the Bone™

INSERT YOUR SITE NAME HERE

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Welcome/Goals

WelcomeIntroduction of Team MembersGoals 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

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Osteoporosis/Low Bone DensityMagnitude of Problem

● 1 in 5 seniors 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

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We are Taking the Lead

We are now a participant of Own the Bone

National Quality Improvement Program

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Why Did AOA Create Own the Bone?

● 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

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What isOwn the BoneTM?

● Web-based quality improvement initiative

● Multi-specialty approach

● Identify, evaluate and initiate evidence-based care for osteoporosis and low bone density after a fragility fracture in patients aged 50 and over

● OTB follows National Osteoporosis Foundation Clinician’s Guidelines

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

● Consistent with Joint Commission Monograph on Osteoporosis

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Own the Bone: Goals

● 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 the RAND and NCQA studies

● Capitalize on the “Teachable Moment”

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Own the Bone: Benefits

● Promotes gathering and recording pertinent information efficiently through a National, Web based registry

● Allows downloadable library of patient education tools to assist compliance against 10 evidence-based measures

● Provides customized, system-generated letters to patients and physicians

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

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Own the Bone: Benefits

● Web-based training● We need to schedule a date with AOA

● Exchange of best practices among participants through ongoing Webinars● Some best practices are included in Getting Started binder and at

www.ownthebone.org

● E-Newsletters

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

● Public relations tools● Press Release templates● Special Own the Bone Participant Logo

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● Demonstrating our leadership role regarding bone health

● Addressing the 82% treatment gap

● Proven QI program ready to implement

● Positive public relations

● It’s the right thing to do

Why We Chose to Own the Bone

Clear Commitment To Bone Health Demonstrated–Stop Future Bone Attacks!

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● National Registry documents and measures participation

● “Failure to Diagnosis” osteoporosis and low bone density associated with related fractures is likely to become a key quality of care and professional liability issue for hospitals and physicians

● Joint Commission (JC) Current efforts are underway to encourage JC to adopt measures

from the JC’s Improving and Measuring Osteoporosis Management into the accreditation process

Why We Chose to Own the Bone

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• Nutrition Counseling● Calcium● Vitamin D

• Physical Activity Counseling● Weight-bearing and muscle-strengthening

exercise● Fall prevention education

• Lifestyle Counseling● Smoking Cessation● Limiting excessive alcohol intake

• Pharmacology● For the treatment of osteoporosis

• Testing● Dual Energy X-Ray Absorptiometry (DXA)

• Communication● Physician referral letter● Follow-up note and educational material to patient

The Program Measures

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.

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Simple, 2-Page Note Taking Form facilitates data management

Own the Bone Note Taking Form

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Property of American Orthopaedic Association (AOA)

Own the BoneWeb-based Data Registry

Simple, Web-based registry facilitates data management

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Property of American Orthopaedic Association (AOA)

Own the BoneWeb-based Data Registry

Data registry login and id● https://ownthebone.clinipace.org

User Name: XXXX Password: XXXX User Name: XXXX Password: XXXX

Own the Bone Web site login and id● www.ownthebone/providers/subscriber

User Name: XXXX Password: XXXX ONE OR TWO?

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● 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

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Implementation

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● Other

Assign roles to team members

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Timeline

Review Web site and program materials

Define trigger system to identify patients

Determine protocol to screen and treat patients

Assign roles to team members

Next meeting

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Next Steps/Goals for Next Meeting

Review implementation plan

Set milestones● Date to start entering data● Number of patients/time period● Establish first data review date

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● Getting Started Binder● Program materials● Best practices, and more

● Visit www.ownthebone.org or contact AOA at 847-318-7336

● Download materials to help explain Own the Bone● FAQ’s● Own the Bone Fact Sheet● Description of System Generated Reports ● Training Webinar

Resources

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AOA Contact Information:

www.ownthebone.org

ownthebone@aoassn.org

Phone: 847.318.7336

Fax: 847.318.7339

AOA Own the Bone Team