​​Big Ideas: Patient-Reported Outcomes: The Impact on Research and Engagement

HealthLeaders Magazine

Sandra Gittlen

December 29, 2015

David C Ayers, MD discusses PROS and FORCE-TJR in this HealthLeaders magazine article.

Read full article here.


PQRS: Health care focus shifts from volume to value
Orthopedics Today
July 2015
“FORCE-TJR submits the surgeon’s data to the PQRS program for [the surgeon] for quality monitoring and to show the improved value of the care [the surgeon] provides,” said Ayers, who is the lead surgeon for FORCE-TJR. “FORCE-TJR has suggested new PQRS measures in orthopedics that CMS has accepted as qualified for PQRS incentive payments. These are measures that all members of FORCE-TJR are already collecting through FORCE, and the measures include patient function and pain which are important to both surgeons and patients,” Ayers said. “No additional data need to be collected in addition to the data already collected for the surgeon to qualify for the surgeon to qualify for full PQRS credit.” In addition to satisfying their PQRS requirement, the FORCE-TJR registry allows surgeons to examine data important to bundled payment programs and the data necessary to negotiate with accountable care organizations, according to Ayers. Also, the registry provides useful quality data to hospitals.

Read full article here.


National Joint Replacement Registry Certified as CMS Qualified Clinical Data Registry
OrthoSpineNews
June 4, 2015
FORCE-TJR, the most comprehensive national registry for total hip and knee joint replacement patients and their surgical outcomes, is now certified as a Qualified Clinical Data Registry (QCDR). In meeting QCDR requirements, FORCE-TJR has successfully collected and tracked more than 30,000 TJR patients across the U.S. in more than 150 provider institutions.  The FORCE-TJR registry continues to expand, providing patient and disease tracking, implant performance, patient-reported outcomes and quality monitoring of TJR.
Read the full article here.


Introducing FORCE-TJR - new national database
Orthopedics This Week

May 4, 2015

Total hip and knee joint replacements (THR/TKR/TJR) are the most common inpatient surgical procedures performed in the United States and the greatest expense in the Medicare budget, according to FORCE-TJR steering committee member Joan A. McGowan, Ph.D. “The FORCE-TJR database is the first to allow independent assessment of total joint replacement effectiveness in terms of both implant performance and improvement in patient pain and physical function,” she said.
Read full article here.


Co-leads of national joint replacement registry to present on patient reported outcomes during national healthcare conference
December, 2014 FORCE-TJR, a national registry on knee and hip replacement surgery, is pleased to announce that co-leads, Dr. David Ayers, MD, chair of the Department of Orthopedics and Physical Rehabilitation at UMass Medical School, and Patricia Franklin, MD, director of clinical research for orthopedics and physical rehabilitation at UMass Medical School will present a lecture on patient reported outcomes (PROs) at the Institute for Healthcare Improvement’s 26th Annual National Forum on Quality Improvement in Health Care from December 7-10.

FORCE-TJR Tapped to Lead “Big Data” Learning Project for Academyhealth’s Electronic Data Methods Forum
OrthoSpineNews
May 28, 2015
FORCE-TJR (the first U.S. total joint replacement (TJR) registry to collect and use patient-reported outcome measures and provide risk-adjusted national norms to guide quality monitoring in TJR) has been named one of three national project awardees by AcademyHealth Electronic Data Methods (EDM) Forum. This year’s awards are designed to stimulate creative strategies for using big health data in ways that will directly improve health care for patients and populations.  FORCE-TJR was chosen by AcademyHealth to lead a year-long project that will bring together experts from leading surgical quality registries, along with patients, clinicians, and policymakers, to identify generalizable lessons and generate a toolkit of promising strategies to improve collection and use of patient-reported outcomes (PROs) in health care.  Kaiser Permanente and University of Washington will partner with FORCE in the project.
Read the full article here.


U.S. Registry Offers New TJR Data
BoneZone
May 12, 2015

Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement or FORCE-TJR, a four-year, $12 million project funded by the Agency for Healthcare Research and Quality, has established the most comprehensive U.S. database on total hip and knee replacement patients and outcomes. With information collected from more than 150 surgeons and more than 30,000 diverse TJR recipients to establish a statistically significant cohort, the database identifies risk-adjusted national benchmarks, including patient risk factors and other clinical measures, to guide surgeon and patient decisions regarding timing of surgery and optimal patient selection.
Read the full article here.


OARSI: Model helps predict readmission after joint replacement
PM 360
May 11th, 2015

Adding clinical factors to a commonly used risk model improves by about 20% the prediction of which patients will be readmitted after undergoing total joint replacement surgery, new data show. The new, combined model employs diagnostic codes and a variety of clinical factors, such as preoperative patient-reported measures – emotional status assessed with the mental component score of the 12-item Short Form Health Survey, moderate to severe pain in other weight-bearing joints (the contralateral joint, the hips or knees, and low back), and history of smoking – and the Charlson comorbidity index. Investigators led by Dr. Patricia D. Franklin, a professor in the department of orthopedics and physical rehabilitation, University of Massachusetts, Worcester, set out to improve on the Centers for Medicare & Medicaid (CMS) risk prediction model for 30-day readmission. Rates of readmission using the model are publicly reported as an indicator of the quality of care at hospitals.

Read the full article by Susan London here


Introducing FORCE-TJR – New National Database
Orthopedics This Week
May 4th, 2015

Meet the database with a name. Funded by the Agency for Healthcare Research and Quality and called FORCE-TJR, this is the first comprehensive U.S. database on total hip and knee joint replacement patients and their surgical outcomes. Total hip and knee joint replacements (THR/TKR/TJR) are the most common inpatient surgical procedures performed in the United States and the greatest expense in the Medicare budget, according to FORCE-TJR steering committee member Joan A. McGowan, Ph.D. 
Read the full article by Biloine W. Young here


Data registry finds younger orthopedics patients are no healthier than older ones

Fierce Medical Devices
April 9, 2015

The Framingham Heart Study has revolutionized cardiology over the decades, leading to insights like the dangers of smoking in the 1960s, elevated blood pressure in the 1970s and more recently, genomic risk factors. Another Massachusetts study is underway, with the intention of becoming the equivalent study in the orthopedics arena, according to Dr. David Ayers, chair of the orthopedics department at the University of Massachusetts Medical School in Worcester.
Read the full article by Varun Saxena here 

Functional Outcomes Data for Joint Replacement Ups the Quality Ante 
HealthLeaders Media
April 2, 2015

Collected by an evolving roster of state registries, functional outcomes data complements data on readmissions and complications and is of value to surgeons, hospitals, and payers as well as to prospective patients.As Medicare and state agencies increasingly turn their scrutiny to complication and readmission rates for the more than 1 million hip and knee replacement surgeries performed in U.S. hospitals annually, new provider registries are asking patients questions that will determine their HOOS/KOOS.
Read the full article by Cheryl Clark here

UMass-led database delivers new insight on joint replacements
Worcester Business Journal
April 1, 2015

Joint replacement surgeries are among the most common medical procedures performed in the U.S., but historically, data that can track their effectiveness hasn't been widely available. But a new database now open to all joint-replacement surgery providers is changing that. A team of doctors, led by researchers at University of Massachusetts Medical School in Worcester, is in the middle of a four-year project funded by the U.S. Agency for Healthcare Research and Quality.
Read the full article by Emily Micucci here

FORCE-TJR Surpasses Original Goal
Orthopedics This Week
March 31, 2015

A mammoth four-year, $12 million national research effort—known as Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR)—has surpassed its original goal and has become the most comprehensive U.S. database on total hip and knee joint replacement patients and their surgical outcomes. The project is funded by the Agency for Healthcare Research and Quality (AHRQ).
Read the full article by Elizabeth Hofheinz here

The Joint Replacement Journey
ADVANCE Physical Therapy and Rehab Medicine
March 31, 2015

Any way you look at the numbers, total joint replacements are huge business. An estimated 50 million U.S. adults are currently diagnosed with osteoarthritis (OA). It's the leading cause of disability in U.S. adults, and costs employers an average of over $9,000 per year per employee.
Read the full article by Jonathan Bassett here

AAOS 2015 conference: Value over volume is the new shift in treating patients
Medical Device Daily
March 30, 2015

Reimbursement. Physician pay. Value over volume. All are words that were pretty common at the American Association of Orthopedic Surgeons (AAOS; Rosemont Illinois), annual meeting held last week at the Venetian/Sands EXPO in Las Vegas.
Read the full article by Omar Ford here

New national database offers benchmarks for total hip, knee joint replacements
Becker’s Infection Control & Clinical Quality
March 23, 2015

After four years and $12 million, an Agency for Healthcare Research and Quality-funded project has culminated in the most comprehensive U.S. database on total hip and knee joint replacement patients and their surgical outcomes. The project and database, known as FORCE-TJR, identifies risk-adjusted national benchmarks, patient risk factors and other clinical measures to help guide surgeons and patients deciding on the timing of surgery and optimal patient selection.
Read the full article by Shannon Barnet here

Registry data to be shared at meeting of orthopedic surgeons
Fierce Medical Devices
March 23, 2015

At the American Academy of Orthopedic Surgeons' annual meeting, which commences tomorrow, findings from the most comprehensive data registry of total hip and knee replacements will be revealed. Dubbed FORCE-TJR, the registry of 30,000-plus patients includes information about risk factors, patient-reported measures of pain, clinical measures like readmission, infection rates, adverse events, and more.
Read the full article by Varun Saxena here

Federally Funded Project Establishes First National Database of Comprehensive Benchmarks for Total Hip and Knee Joint Replacement
Fierce Medical Devices
March 23, 2015

A 4-year, $12 million national research project funded by the Agency for Healthcare Research and Quality (AHRQ) has surpassed its original goal, culminating in the establishment of the most comprehensive U.S. database on total hip and knee joint replacement patients and their surgical outcomes.
Read the full article here

Studies Suggest More Joint Replacement Patients Under Age 65 Years Have Severe Osteoarthritis
Pain Medicine News
March, 2015

The fastest-growing population of patients undergoing total hip replacement (THR) and total knee replacement (TKR) in the United States is age 65 years or younger. Despite being at least 10 years younger than the “older” people getting THR or TKR, an increasing number of these younger patients have more severe osteoarthritis (OA) and are in worse shape at the time of surgery with regard to pain scores and emotional/mental health, according to data from two companion studies reflecting national trends in the United States.
Read the full article by Alice Goodman here

Letter to the editor: Patient input is critical for value-based healthcare
Becker’s Hospital Review
January 29, 2015

The pressure to move healthcare from volume to value is ever increasing. ("Plans for Medicare Payment Overhaul Receive Mixed Reviews", January 28).  We know we are all going to get there eventually, but will it be for the sake of the bottom line or the sake of the patient? As efforts continue to define value in healthcare, it is critical to include the patient perspective, as well as clinical data such as complications and readmissions.
Read the full article by Dr. David Ayers and Dr. Patricia Franklin here​​