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Five Health IT Trends to Look For

Dan Drawbaugh is CIO of University of Pittsburgh Medical Center (UPMC), a $10 billion nonprofit health care provider with 55,000 employees and a 2-million-member insurance company. Among 5 “underrated” health IT trends Drawbaugh is watching are systems for healthcare reform and risk management. Other areas to watch according to Drawbaugh include big-data analytics, which according to an InformationWeek Healthcare study, only 15% of healthcare providers have implemented. Drawbaugh also expects to see more joint IT product development by healthcare providers, technology convergence, and more technology aimed at patients for home monitoring. Read more.

PA and Nurse Practitioners Shortages Looming

According to an article on, over the next 10 months, millions of newly insured Americans will be seeking medical care. Many experts are concerned that there won’t be enough doctors, internists, and pediatricians to handle the huge volume of new patients. According to StaffCare, a physician staffing company, 10% of all staffing requests from hospitals and clinics were for temporary physician assistants and registered nurses, up from 2% of similar requests in 2010. According to Sean Ebner, StaffCare’s president, “there are not enough PAs and NPs to make up for provider shortages in primary care and other areas.” Read more.

The Role of Orthopaedists in the Boston Bombing

On April 15, 2013, on a sunny day in Boston, thousands gathered to watch the oldest marathon in the US. They were cheering family, friends and colleagues who were accomplishing a feat they had trained for all year. No one expected the next wave of events – two bombs exploded near the finish line of the race, killing three people and injuring more than 260. The pictures and images looked like a warzone. What followed next was also unprecedented. Orthopaedists, first responders, trauma surgeons, other medical professionals, runners, and spectators jumped in to help the bomb victims, many using tourniquets to stop the bleeding.

Many of the surgeons treating these victims had previous military training, helping 14 people who ended up with amputations and a dozen other victims whose limbs so far have been spared. According to Dr. James Ficke, chairman of the department of orthopedics and rehabilitation at San Antonio Military Medical Center, “a multidisciplinary approach that involves everyone from plastic and orthopedic surgeons to therapists is important.”

According to NBC News reporters, Bill Dedman and John Schoen, from a financial perspective, the Boston Marathon bombing will cost as much as $333 million in losses to the local economy and infrastructure damage. The total cost of care for 70 hospitalized patients could exceed $9 million, according to one calculation. Read more.

A Look Back at Politics in 2013

2013 has been a year filled with news impacting the world of orthopaedics. Terry Canale, MD, Editor-in-Chief of AAOS Now, has compiled a top ten list:

  1. The Affordable Care Act
  2. No Fiscal Cliff or Sustainable Growth Rate (SGR) Fix
  3. The Value of Orthopaedics
  4. Operation Walk USA
  5. Metal-on-metal
  6. Concussion and Chronic Traumatic Encephalopathy (CTE)
  7. Orthopaedic medications
  8. Yale Open Data Access (YODA) results
  9. Boston Marathon bombings
  10. AAOS initiatives

Aging Population, Rising Middle Class Could Boost Medical Device Companies

An aging population in China combined with a growing middle class will affect U.S. imports  of U.S. made medical devices according to Michael Taylor, Senior Director of International Affairs and Trade at the Washington-based Society of the Plastics Industry. With China and Asia becoming a huge market for global healthcare-related companies, Mark Bonifacio, owner of Bonifacio Consulting Services, says Original Equipment Manufacturers are setting up design centers in Asia to be closer to their customers. According to Len Czuba, principal of Czuba Enterprises, for medical devices entering the market, the trend is moving towards mobile devices, he says, “Healthcare is moving away from hospitals and into home environments and devices are shifting towards ability to be used by non-doctors.”

Fracture Treatment App for Orthopaedic Surgeons

The AO Surgery Reference is a comprehensive portal of surgical knowledge that includes hundreds of surgical procedures and approaches, tools to help make surgical decisions, and access to hundreds of pages of previously published AO material. Developed by the AO Foundation, the reference is now available via iPhone, iPad, and Android apps. This app is a good starting point to access information about the treatment and management of traumatic fractures. According to a recent JBJS survey of orthopaedic surgeons, AO apps were mentioned second to Epocrates as a favorite medical mobile app.

Need to Know Dates for Physicians in 2014

Almost everyone will be affected by the Affordable Care Act in one way or another. For many, it will mean an abundance of new patients because as of Jan. 1, 2014, twenty-two states and the District of Columbia expanded access to Medicaid to children and adults with individual or family incomes less than 133% of the federal poverty levels. Additionally, Jan. 1st means the beginning of Stage 2 requirements of the CMS meaningful use program for EHRs. February 28 is also the reporting deadline for physicians to submit performance data that qualifies for a bonus through the Physician Quality Reporting System. To see more important dates and deadlines for physicians and healthcare providers, see Medscape’s slideshow (login required).

Gawande’s Winding Road from Politics to Surgery to Journalism

In an interview with Medscape’s Dr. Eric J. Topol, editor in chief, Dr Atul Gawande discusses his journey from medical school to working in the Clinton administration to being a journalist. Dr. Gawande is currently a Professor in the Department of Health Policy and Management at the Harvard School of Public Health and a Professor of Surgery at Harvard Medical School.

In comparing surgeons with politicians, Gawande said, “Surgeons are grappling with having limited information and knowledge, imperfect science, but have a necessity to act in the face of both imperfection in their own abilities and imperfect knowledge in the world. I saw a lot of the same incredible range of characters and people [in politics and the operating room].” Dr. Gawande concluded that this is a fascinating time in medicine because “we’re all trying to figure out how to make systems work instead of just using drugs and devices.”

Trends in Social Media Usage among Orthopaedists

In a study by JBJS conducted with orthopaedic surgeons in December 2013, 19% report using Facebook for professional purposes, and 39% report using LinkedIn. Only 8% report using Twitter regularly for professional purposes, and there is no consensus on a single, dominant Twitter feed being followed.

When asked how social media will affect orthopaedic care, surgeons responded with a mixed bag of concerns regarding privacy issues, credibility, and direct-to-consumer marketing. However, 21% predicted that social media will have a positive impact on orthopaedic care, primarily for the patient. As one orthopaedic surgeon put it, “[social media] will be the place patients go for reviews of physicians, or to share info.”

According to Howard J. Luks, MD, it is important to have an online presence to help patients learn more about your practice, your qualifications, and find relevant videos. Beyond mainstream sites like LinkedIn, his recommendations for increasing your online presence include sites such as Doximity, HealthGrades, Vitals, ZocDoc, Yelp, and Google Places for Business.

For more detail on the JBJS technology usage study, watch for information about our upcoming webinar.

The Many Challenges of the Pharmaceutical Sales Representative

If you are a sales rep in the pharma market, 6 minutes may be as long as you get with your customer, often while standing on your feet. In a secret-shopper study done by BioPharma Alliance among 200 specialists, undercover former drug reps observed 350 pharmaceutical rep visits. From their observations, nine out of ten calls lasted 6 minutes and almost half were conducted while standing. According to the study, 83% of primary care physicians look for their rep to be an expert when the drug is new compared to 76% when the drug is already established. However, when doctors were asked about their frustrations in dealing with sales reps, topping the list was, “no new information.” Similarly, “pushy” and “aggressive” sales reps are also top annoyances.

According to Mike Luby, of consultancy BioPharma Advisors, “The biggest problem pharma has is admitting they have nothing new and adjusting their approach.” Luby goes onto say, “Consider the doctor who sees the rep waiting for them at the sample closet. They don’t know if it is new information, good science, a valued medical update waiting for them, or someone waiting to tackle them and pretend that they have something new on an old brand that hasn’t had any new information in years. So it burns doctors out. It also drags all reps down, because as a doctor, you don’t know until you are in the conversation, when you’ve invested time you will never get back.”