LITTLE ROCK — The University of Arkansas for Medical Sciences (UAMS) is now a partner site in a nationwide effort to improve care for orthopaedic conditions by using statistics on outcomes that can help monitor a response to surgery and maybe help determine if a procedure is right for them.
The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed by the National Institutes of Health for widespread use across the health care system to better measure patients’ perceptions of their medical conditions and treatments.
As a PROMIS site, UAMS orthopaedic patients will have the opportunity to complete brief questionnaires to give providers more insight into how their medical conditions are affecting their quality of life.
Surveys in the clinic on user-friendly iPads gather information on physical, social and psychologic factors like pain and mobility before and after the procedure, activity level, mental health and other factors that can influence the success of an orthopaedic surgery.
“Musculoskeletal health affects most of the population, and costs related to care are some of the greatest in the U.S. health system – over $162 billion a year,” said David Bumpass, M.D., associate professor of orthopaedic surgery, who is heading the PROMIS effort at UAMS. “Despite this, much research still needs to be done on how effective many orthopaedic procedures are, and how much of an improvement in quality of life patients see afterward.”
For example, one patient considering a knee replacement may look at the statistics and discover that patients of similar age, activity level, and pre-surgery pain saw a large decrease in pain after surgery and an increase in mobility. However, a second patient may look at the statistics and discover that similar patients only reported minor improvements after surgery. Patients can weigh this information against their other priorities, such as cost and desired participation in sports, exercise or returning to work.
“Having better data will enable physicians and patients to work together to find the right solutions that best meet the patient’s goals and lifestyle,” said Jeffrey Stambough, M.D. assistant professor of orthopaedic surgery, who is also part of the study team. “Medicine is moving toward what is known as ‘value-based care’ – in which physicians are reimbursed on how well they take care of patients and not just by the number of procedures they do. With our participation in PROMIS, UAMS is leading Arkansas toward establishing the value-based benchmarks needed to make this shift – which ultimately better serves patients as well.”
The Department of Orthopaedic Surgery is piloting PROMIS with spine and joint-replacement patients, but the intention is to expand it to other surgeries and procedures in the department. The program is also easily applicable to other disciplines.
“As the only academic medical center in Arkansas, it is part of UAMS’ public mandate to be a state and national leader in using research to improve care,” Bumpass said. “We make data-driven decisions every day at UAMS, and through projects like PROMIS, we are able to push innovation forward as we move toward value-based care across the country.”
The PROMIS project at UAMS is also supported by the UAMS Translational Research Institute’s Clinical and Translational Science Award (CTSA) from the National Center for Advancing Translational Sciences of the National Institutes of Health, grant UL1 TR003107.