Today’s Top Story
AAOS, AMA, and other organizations form task force to address opioid epidemic.
AAOS, the American Medical Association (AMA), and 25 other medical societies have convened a task force to collaboratively address the opioid public health epidemic by identifying and implementing best practices. The group has developed a roadmap with the goal of bringing healthcare professionals and patients together as partners on the path to eliminating this public health concern. Initially, the group plans to focus on the following priorities:

  • Use of state-based prescription drug monitoring programs (PDMPs)
  • Discussing pain management treatment options with patients
  • Robust education activities to meet the needs of specialty, practice, and patient populations

In addition, the group plans to work with states to ensure PDMPs protect patient privacy, contain relevant and reliable data, allow care teams to seamlessly integrate data into their work flows, and enable data sharing across state lines. Read more…
View the participating organizations…

Other News

Lawmakers introduce legislation to improve meaningful use program.
The U.S. House of Representatives is considering legislation that would, if enacted, provide increased flexibility in the meaningful use program and ensure that electronic health records systems address interoperability challenges. In addition, the bill would delay Stage 3 rulemaking to align it with technology advancements and a new incentive-based payment system designed to combine current quality programs. The bill would also harmonize reporting requirements and institute a 90-day reporting period for each year, regardless of stage or program experience. Read more…
Read more on Advocacy Now…

Study: Long-term outcomes similar for patients undergoing Achilles tendon repair and treated postoperatively with early mobilization or immobilization.
Findings from a study conducted in Finland and published online in The American Journal of Sports Medicine suggest similar long-term outcomes for patients who have undergone Achilles tendon rupture repair and are treated postoperatively with either early weightbearing with early mobilization or early weightbearing with early immobilization in tension. The authors conducted a randomized, controlled trial of 50 patients with acute Achilles tendon rupture who received either early movement of the ankle between neutral and plantar flexion in a brace for 6 weeks or Achilles tendon immobilization in tension using a below-knee cast with the ankle in a neutral position for 6 weeks. Among the 37 patients with 11-year follow-up, they found no significant difference between cohorts in mean Leppilahti score, mean isokinetic plantar flexion peak torque deficit, or average work deficits in plantar flexion. However, regardless of patient satisfaction with the surgical treatment, the authors noted that calf muscle strength did not recover normally even at 11-year follow-up. Read more…

Study: Standards for blood clot prevention after surgery may be set too low.
A research letter published online in the journal JAMA Surgery argues that “best-practice” standards for the prevention of blood clots after surgery may be set too low. The researchers conducted a retrospective review of 128 patients treated at a single center, all of who developed hospital-acquired venous thromboembolism (VTE) and were flagged by the Maryland Hospital Acquired Conditions pay-for-performance program. They found that 36 patients (28 percent) had non-preventable, catheter-related upper extremity clots, leaving 92 patients (72 percent) with potentially preventable clots. Of those patients, 79 (86 percent) were prescribed clot-preventing medications, yet only 43 (47 percent) received “defect-free care.” Of the 49 patients (53 percent) who received suboptimal care, 13 (27 percent) were not prescribed risk-appropriate clot-preventing drugs, and 36 (73 percent) missed at least one dose of appropriately prescribed medication. The researchers note that existing VTE care goals set by The Joint Commission and CMS say that one dose of clot-preventing medication is given to patients within the first day of hospitalization, but data suggest that may not be enough. Read more…
Read the excerpt…

Congress approves bill to require hospitals to tell Medicare patients when they receive observation care without hospital admission.
Kaiser Health News reports that both houses of Congress have approved legislation to require hospitals to tell Medicare patients when they receive observation care yet have not been admitted to the hospital. Under the so-called NOTICE Act, hospitals would be required to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implications. While under observation care, enrollees are ineligible for more comprehensive Medicare hospitalization coverage, and may also be ineligible for Medicare’s limited nursing home benefit for care after admission to a hospital. President Obama is expected to sign the legislation. Hospitals will be required comply with the act 12 months after it is enacted. Read more…

IOM report addresses wait times and timeliness of care.
A report released by the Institute of Medicine looks at timeliness in access to health care. The authors note that delays can negatively affect health outcomes, patient satisfaction, healthcare utilization, and organizational reputation. They offer the following basic principles to develop systems-based approaches to scheduling and access that provide immediate engagement of a patient’s concern at the point of initial contact:

  • Matching supply with projected demand through formal, ongoing evaluation
  • Immediate engagement and exploration of patient’s needs, at the time of inquiry
  • Patient preference on the timing and nature of care, invited at inquiry
  • Need-tailored care with reliable, acceptable alternatives to clinician visits
  • Surge contingencies, or provisions for accommodating patients’ acute issues that cannot be addressed in a timely manner
  • Continuous assessment of changing circumstances in each care setting

The writers argue that professional societies and organizations should work with standards and certification organizations to assess and improve scheduling and access. Read more, with related links…

August AAOS Now is available online and in ePub format!
AAOS members will soon receive the print edition of the August issue of AAOS Now, but the electronic editions are already available on the AAOS Now website. This month’s issue includes an article on the relaxation of implementation requirements for ICD-10, a discussion on bundled payments, a look at the new Orthopaedic Learning Center, and much more! Read more…
Read “CMS Relaxes ICD-10 Implementation Requirements”…
Read “Are Bundled Payments Here to Stay?”…
Read “New OLC is Better than Ever”…
Download and read the ePub edition of AAOS Now…

Call for volunteers: The Joint Commission Board of Commissioners.
AAOS seeks to nominate a member as the AMA-appointed member of The Joint Commission Board of Commissioners. The board consists of 32 voting members, including physicians, administrators, nurses, employers, a labor representative, quality experts, a consumer advocate, and educators. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, nominees must be active members of the AMA at the time of appointment and throughout the term of service; may not be board members, advisory committee members, elected officers, employees, or paid independent contractors of other accrediting organizations; and may not hold leadership positions in healthcare organizations accredited by other accrediting organizations. Finally, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, a conflict of interest form (contact Kyle Shah, below), and a letter of interest highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted to Kyle Shah by Aug. 5, 2015 at 11:59 p.m. CT at: shah@aaos.org
Learn more and submit your application…(member login required)