Ingrid Hein

February 25, 2016

ORLANDO, Florida — The new Centers for Medicare & Medicaid Services payment program, which comes into effect April 1 in the United States, will be among the hot topics here at the American Academy of Orthopaedic Surgeons (AAOS) 2016 Annual Meeting, as specialists debate the growing role of patient feedback.

James Ficke, MD, from the John Hopkins University School of Medicine in Baltimore, who is chair of the AAOS central programming committee, predicted that a lot of discussion this year will be centered around patient-reported outcomes.

"What does the patient think about their surgery? We, as a profession, are gaining more focus on the patient," Dr Ficke explained. "Would they have their surgery again? How pleased were they with the surgeon and with the experience? And how do we, as surgeons, assess it?"

The new Medicare Comprehensive Care for Joint Replacement model holds participant hospitals financially accountable for the quality and cost of lower-extremity joint replacements and incentivizes the coordination of care among hospitals, physicians, and postacute-care providers, beginning with admission to the hospital and ending 90 days after discharge.

We, as a profession, are gaining more focus on the patient.

Although it is not really something they worried about in the past, hospitals, and ultimately surgeons, will be responsible for treatment through to the recovery stage, Michael Kelly, MD, from the Hackensack University Medical Center in New Jersey, told Medscape Medical News.

Dr Kelly said he was reticent about the model at first, but the research is showing that it could change things for the better.

"A lot of the research reflects on quality of patient care, cost efficiency of patient care, and studies looking at increasing discharge to home," he explained. "One study showed that if patients were discharged to home, instead of going to skilled nursing centers or acute rehabilitation facilities, readmission was reduced by 25%. That's huge."

Dr Kelly will be discussing research on this topic during a section devoted to the reconstruction of adult knees.

New research will be abundant; 926 peer-reviewed papers and 576 posters will be presented. And there will be a lot of discussion about where we are with joint replacement, said Dr Ficke, who specializes in foot and ankle injuries.

"If you're going to break your leg in March, the best place to be is in Orlando," he quipped.

New Dynamic Presentation Formats

Two brand new presentation formats will be launched at the meeting that promise to keep the conference lively. Flash 5: What's Coming Down the Pike gives experts the opportunity to share critical points and takeaways on specific topics in 5-minute bursts of information.

Then, in the Hip Showdown, the audience will weigh in and vote for the winner as experts debate "reconstruction or not?" Later in the week, four shoulder and elbow surgeons will battle over the management of four-part humeral fractures.

"We wanted to give people an attention-grabbing, short bite, quick dose of information," said Tad Gerlinger, MD, chair of the AAOS central instructional courses committee.

There will also be a dozen experts presenting candid talks on topics ranging from social media and reputation management, to payment management and robotics in orthopedics in The Way I See It session.

We wanted to give people an attention-grabbing, short bite, quick dose of information.

Given the magnitude of this year's conference — more than 12,500 surgeons and 20,000 attendees are registered — it's imperative to plan your week carefully. "It's such a large meeting that you have to plan what you're doing for nearly every minute. You can't just walk in and look around and decide where you're going," Dr Ficke explained.

The annual meeting has grown significantly over the years. Since 2000, the number of papers, posters, videos, and symposia has more than doubled in volume. The week will be jam-packed, with 32 symposia, 88 scientific exhibits, a full specialty day program, 22 expert-guided poster tours, 80 videos, and ask the expert sessions where attendees can bring case challenges on a flash drive.

"Frankly, I would download the app and look for relevant topics. Look up trauma, tibia fractures, everything that's relevant will come up," Dr Ficke told Medscape Medical News. The My Academy App gives participants the ability to view, search, and schedule all conference activities. It has maps and even a messaging feature to help members contact colleagues during the conference. "That's really the best way to make sense of the meeting."

Dr Gerlinger said he is especially excited that there has been a dramatic increase this year in case presentation courses, which cater to a range of learning styles. During these sessions, expert faculty will facilitate discussion in breakout groups at tables with laptops. "Interactive learning is very popular," Dr Gerlinger pointed out, noting that advocates of this format were really enthusiastic for more of this type of session. "Everyone learns differently, and we're really starting to address the different learning styles," he said.

A pilot academic-tracks program is new this year. For surgeons who want to recertify, there are academic tracks, according to specialty, that will help them prepare for their exam. This year, the focus is the spine, but more tracks will be added in the future.

Dr Ficke has disclosed no relevant financial relationships. Dr Kelly reports that he is a paid consultant for Pacira Pharmaceuticals and Zimmer, and owns Pfizer stock. Dr Gerlinger reports that he is a paid consultant for Smith & Nephew.


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