President's Monthly Update - April 201204.09.2012
Dear fellow ASES members:
It has been several months since my last update on our organization’s initiatives. Much has happened and my delay in reporting to you all has been in an effort to catch up with the speed of these developments. Below is a summary of some of the initiatives which are underway. As always, I welcome your comments and questions.
Jon JP Warner, MD
Value-Based Committee Activities:
Drs. Higgins and Morrey presented at the Executive Committee meeting in San Francisco this February on the substantial initiatives of the Ad Hoc Value-Based Care Committee. A brief overview is as follows:
Initiative 1: The Value-Based Committee must become a standing committee rather than an ad-hoc committee. This is, perhaps, the most important initiative for our organization. With the emphasis on healthcare reform and the unprecedented challenge of proposed changes in care delivery, our society must be in a position to be proactive. This can only happen if this committee becomes part of our overall strategy as a society. This will be a bylaws change, on which we will vote at our closed meeting this Fall.
Initiative 2: Under Drs. Higgins and Morrey’s leadership, the committee has initiated a collaboration with AAOS to establish our collective definition of evidence that is appropriate to guide care and make recommendations for insurance coverage. Dr. Kevin Bozic, who is chair of the AAOS Council on Research and Quality, has been working to collaborate with us and guide us. Some of this initiative will involve input from the Harvard Business School and discussions with insurance providers (see below).
Initiative 3: We are working with our sister societies, AANA and AOSSM to establish an independent entity which will serve as an advocacy arm for outcomes measurement of quality. The goals of this organization will be as follows:
GOALS AND OBJECTIVES
The goals of the entity are to improve the quality, outcomes, and cost-effectiveness of musculoskeletal care through the achievement of the following objectives:
1. Ensure patient access to appropriate and high quality musculoskeletal care.
2. Educate patients, policy makers, regulators and providers on appropriate care pathways.
3. Help to define “value” in musculoskeletal care in terms for treatment outcomes and cost effectiveness.
4. Promote musculoskeletal care as a critical component of patients’ overall health.
5. Analyze, validate, and disseminate quality evidence that aids in health policy and advocacy.
6. Develop, validate, and disseminate quality metrics that are measurable, sustainable, achievable, specific, and relevant.
7. Identify, review, and support health policy and advocacy pertaining to musculoskeletal care at both State and Federal levels.
Tufts Healthcare Initiative: The value based committee has considered and delivered on the invitation of the medical director of Tufts Healthcare (located in Massachusetts) to have the ASES guide criteria for approval of reverse prosthesis procedure for it’s members. This has been an unprecedented offer from an insurance company. Our plan for next steps is to meet with the medical director to address issues of measurement of quality outcomes as a method to clarify who should be approved to perform this procedure. This initiative promises to bring great value to all stakeholders including patients, hospital, insurers, and physicians.
Clinical Practice Guidelines: At our meeting with the AAOS leadership at the Annual AAOS meeting in San Francisco, they indicated their support of specialty societies defining appropriate use criteria. We discussed the concerns of our membership regarding the recent Clinical Practice Guidelines for rotator cuff treatment, published by the AAOS, and our perception of the problem with the levels of evidence used to arrive at these guidelines. AAOS leadership indicated that their guidelines specifically state that these are not for determination of coverage and access to care but rather were intended for clinicians as a guide for treatment. At this time the position of the ASES leadership is that these guidelines do not accurately reflect the value of treatment of rotator cuff disease and we are working to clarify what we believe is the meaningful evidence for treatment. One area of agreement we did have with AAOS leadership was that lack of evidence does not mean lack of effectiveness. The problem we have is that the criteria for evidence are not appropriate to answer the questions which they pose regarding rotator cuff treatment.
Social Media and Website Committee:
Dr. Matthew Provencher reported on the recommendations of the Web and Social Media Committee with the following initiatives for our society.
1. Work with both www.vumedi.com and www.g9md.net to enhance the brand of ASES and our commitment to education.
2. Create a member map for our society which graphically lists all members on a global map.
3. Create a virtual committee conferencing program which reduces the amount of work to effectively communicate and move forward with ASES initiatives.
4. Create an ASES Channel with a link to our webpage for videos the society wishes to feature. This will be entitled “ASES Presents”.
5. Brand member videos on both vumedi and g9md sites.
Strategy for the Society including membership question:
The Planning and Development Committee has been charged to consider the over-arching question of Strategy for the ASES. Subcommittees are considering questions such as growth and membership criteria for our society. This month, we anticipate their recommendations will be given to the Executive Committee. Many recommendations may require a significant change for our organization and it is likely we will be considering these are our business meeting this Fall. More to come.
The Closed Meeting in Sea Island, Georgia, October 2012:
Drs. Higgins and Ticker have been hard at work in their goal of creating a unique meeting for all. They have sent a variety of questionnaires to membership to collect important information that will allow them to create a great meeting. More to come.