1. Outcomes Data = Power Surgical Outcomes System = SOS

2. Conflict of Interest Statement Fellowship Grants and/or Consultant Arthrex Smith Nephew Synthes Mitek Share Holder Tuckahoe Surgery Center & St. Mary’s ASC Comp Recovery AANA President and Member of the Board of Directors AAOS Coding, Coverage and Reimbursement Committee - member

3. Direction of Medicine/Orthopedics  End of Fee for Service – 2017?  Change from “Volume to Value” VALUE = OUTCOMES/COST  Creation of “Value Metrics” Who determines the metrics? Providers vs. Payors Who will collect the data? Providers vs. Payors How will that affect your “Administrative Burden”

4. Societies Leading Change to Value

5. Expected CMS Data Collection Requirements (My Opinion)  Mortality  Complications - expensive Return to the OR Infection/DVT  Patient Reported Outcomes (PRO’s)

6. AANA’s Goals - Outcomes Data Collection AANA’s Goals - Outcomes Data Collection  Provide our members with a turn-key system  Minimal burden for the surgeons  Inexpensive without expensive maintenance  System that avoids excessive regulations  Unite similar societies – AANA, ASES, AOSSM, AAOS*  Determine our own metrics with consistent data elements (AANA Favorites)  Share our data to protect patient access to care

7. Specifics - Two SOS Models Research ▪ IRB approval and oversight ▪ Written patient consent Healthcare Operations (HCO) ▪ Standard of care procedures ▪ No IRB oversight ▪ No written patient consent ▪ Need local IRB approval and consent if use for research in the future the future

8. Minimum Data Set and Research Sets  Shoulder - Hawkins/Tokish Core ○ VR-12, SANE, ASES, ○ Oxford Shoulder Score (for Europeans) Research ○ WORC (rotator cuffs) ○ WOSI (shoulder instability) ○ WOOS (shoulder osteoarthritis) ○ Penn Shoulder Score (general)

9. SOS Value Highlights ▪ Patient Reported Outcomes - Subjective ▪ Automatic emails ▪ Patient compliance tracking features ▪ Co-morbidity indices for risk adjustment ▪ VR-6 for cost-effectiveness and QALY ▪ “Favorite” templates ▪ Smart Device and tablet compatible ▪ Surgeon “Administrative Burden” = 2 minutes post-op!!!!

10. SOS = AANA Member Benefit!  AANA dues – currently $600/year  SOS - $1800/year incredible VALUE  Education grant from Arthrex!  Access to all the SOS programs (joints, spine, pediatric, hand, etc.)  Business People!!!

11. SOS – Ultimate Goal AANA Member BUY-IN Data Collection

12. Questions?