Leveraging technology: Using big data to make better purchasing decisions in the orthopedic service line



In a webinar hosted by Becker's Hospital Review on July 31, a panel of experts discussed data collection efforts by national orthopedic registries as well as new solutions that make supply purchasing in the orthopedic service line more effective.

Big data presents a huge opportunity to improve patient care; however, the sheer volume of data prevents healthcare providers and administrators from using it in a meaningful way.

Here is a snapshot of orthopedic data being collected and what technology can do to help make it actionable in terms of supply purchasing.

Big data collection in orthopedics today
The American Joint Replacement Registry is a national registry that collects data on total joint replacement procedures with the aim of improving arthroplasty patient care. According to Caryn Etkin, PhD, MPH, director of analytics at AJRR, the registry has enrolled around 300 hospital members in 48 states, and it is the only orthopedic initiative designated a qualified clinical data registry by CMS.

"AJRR's goal is to capture 90 percent of all TJR procedures in the U.S.," she said.

"The registry is currently collecting level-one data, which includes patient-specific data, hospital information, surgeon data and procedure specifics," said Randolph Meinzer, director of information technology at AJRR. "Toward the end of 2014, it will begin collecting level-two and -three data, which will include metrics such as length of stay and operative and postoperative complications. It will also allow hospitals to assess patients' health outcomes in the long term."

According to Mr. Meinzer, the data being collected by the AJRR is beneficial for several stakeholders, including hospitals. The registry allows access to de-identified national benchmarks related to TJR as well as institutional information. "The AJRR also provides hospitals with online demand reports and quality metric dashboards," he said.

Another registry that is adding to the growing volume of TJR data is FORCE-TJR, which is collecting data from more than 30,000 diverse patients of 150 orthopedic surgeons.

"Our data capture is different as we are not hospital-centric but patient-centric. We can also track the patients for decades," said Patricia Franklin, MD, MBA, MPH, principal investigator at FORCE-TJR and professor at the University of Massachusetts Medical School in Worcester. FORCE-TJR aims at monitoring and improving outcomes after TJR, including patient-reported pain, function and adverse events.

FORCE-TJR uses a confidential web-based system that allows members to see data for all of the patients. Also, every quarter members receive a report that includes data such as patient mix, patient selection and timing of the procedure, TJR patient-reported outcomes as well as the pain level and adverse event rate.

"Members can use these to figure out changes that need to be made in their hospitals," says Dr. Franklin. "Changes in patient selection, for example."

Leveraging big data: Elementary, my dear Watson
Supercomputer Watson has already proved itself to be a Jeopardy winner in 2011, but this technological marvel can now assist hospitals in making evidence-based decisions in supply purchasing.

"The most unique and interesting aspect of the Watson supercomputer is that it can navigate the complexities of human speech," said Stephen Gold, vice president of marketing and sales operations at Watson solutions at IBM. "It has the ability to break down a query into all possible interpretations, explore them all and come back with the most relevant answer. Watson also learns and gets smarter with time. We have taken Watson technology and applied it to healthcare. Medical information doubles every five years and this data needs to be made actionable. Levering this technology is a game-changer."

Currently, when hospitals and providers select medical devices, the decision is based on relationships rather than data. This is problematic for several reasons, including the fact that physicians are sometimes given financial incentives to recommend or use one vendor over another. Also, device cross-reference platforms are difficult to curate for hospitals and combined public and private data is non-existent.

"Some hospitals have value-analysis committees in place that are extremely helpful, but the lack of relevant data affects their role as well," said David Rodriguez, vice president of marketing and solutions management at MD Buyline. "And once the committee gets the data, the question of analysis comes in. Sometimes, analysts have to be hired, and the analysis can take months."

Hippocrates powered by IBM Watson is a web-based solution that leverages the Watson technology for improving orthopedic supply purchasing decisions at healthcare organizations. It brings together data from regulators, vendors, hospitals, patients, registries and pricing data to allow healthcare providers to make evidence-based decisions regarding buying implantable devices, orthopedic or otherwise.

"With all this data laid out for them, hospitals can make decisions that work for them," said Mr. Rodriguez. "Having all the information in one place is very useful when surgeons and administrators come together to debate device selection."

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