ONC and CMS consider patient ownership of health data
During the 2018 Interoperability Forum, the Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare & Medicaid Services (CMS) discussed the importance of patient ownership of health data for interoperability. CMS regulators may require that providers share patient data through a universal, standardized platform to prevent information blocking. CMS Administrator Seema Verma said that allowing patients to have complete control of their health data would bring about “a new era of digital health.” Ms. Verma added, “Liberating data will drive innovation through the entire healthcare system and will allow the system to deliver value to patients.”
Study identifies risk factors for re-nonunion following primary revision in femoral shaft nonunion
Primary revision method and adjuvant autogenous bone grafting (ABG) procedure were the most common risk factors for re-nonunion after primary revision in femoral shaft nonunion subsequent to failed intramedullary nailing, according to a retrospective study published online in The Journal of Orthopaedic Surgery and Research. Researchers assessed 63 cases in 61 patients who underwent primary revision with either exchange reamed nailing (ERN) (n = 33, 52.4 percent) or augmentative compression plating (n = 30, 47.6 percent) between June 2007 and June 2015. Adjuvant ABG was performed in 39 cases (61.9 percent). Re-nonunion was diagnosed in 18 cases (28.6 percent) after primary revision. The strongest risk factors of re-nonunion were primary revision with ERN and adjuvant ABG procedure. Other risk factors included smoking, body mass index (≥ 30 kg/m 2), site of nonunion, and bone defect (≥ 5 mm).
Study: Disease progression following lateral versus medial UKA
A study published online in The Journal of Arthroplasty found that osteoarthritis (OA) may advance more quickly in patients undergoing lateral unicompartmental knee arthroplasty (UKA) compared to medial UKA. Researchers graded preoperative and one- and five-year postoperative radiographs for OA in 20 lateral and 114 medial UKA patients in the unoperated tibiofemoral (TF) and patellofemoral (PF) compartments using the Kellgren (0–4-point global scale for OA), Ahlbäck (0–5-point scale based on joint space narrowing), and Altman (0–12-point composite criteria score) scales. All mean disease grades for the TF and PF compartments worsened over time. Kellgren grade changes occurred faster five years postoperation in lateral patients in the TF and PF compartments, and Ahlbäck grades increased faster in the TF compartment. After adjusting for confounding factors, the Kellen grade increased for the TF compartment in lateral and medial patients by 1.1 and 0.6 points, respectively.
CMS announces application period for MAQI Demonstration
CMS is accepting applications for participation in the Medicare Advantage Qualifying Incentive Arrangement (MAQI) Demonstration. The MAQI Demonstration is designed to test if exempting clinicians who are eligible for Merit-based Incentive Payment System (MIPS) and participate in certain Medicare Advantage Organizations (MAOs) from MIPS reporting requirements will increase or maintain participation in payment arrangements similar to Advanced Alternative Payment Models with MAOs. The deadline to apply is Sept. 6.
Medical technology company Conformis completed two surgeries using The Conformis Hip System, a total hip replacement system that converts a patient’s CT scan into a three-dimensional model to develop a preoperative, individual surgical plan, which the surgeon receives before the operation. The first two surgeries, performed at JFK Medical Center in Atlantic, Fla., were part of a limited launch, and a full launch is expected in 2019.
ACL reconstruction techniques continue to evolve, but hurdles lie ahead
Anterior cruciate ligament (ACL) reconstruction remains one of the most common procedures in orthopaedic surgery, with an estimated 100,000 performed annually in the United States alone. Over the past 40 to 50 years, treatment of ACL injuries has evolved, from nonanatomic extra-articular procedures with large incisions to entirely arthroscopic anatomic reconstructions; from postoperative casting and delayed weight bearing to immediate range of motion and early rehabilitation; and from minimal published literature to an abundance, with more than 1,200 articles published on the topic annually in recent years. Understanding this history helps surgeons evaluate patients treated with the older techniques.
Last call: Apply for Patient Safety Committee member-at-large positions
The Patient Safety Committee has open member-at-large positions for two-year terms that run from March 18, 2019, to March 12, 2021. The committee supports the development, validation, and dissemination of culture and processes that improve orthopaedic surgical safety and informs Academy policy regarding these issues. The last day to submit an application is Aug. 15.