1. 1 AOA Own the Bone™ INSERT YOUR SITE NAME HERE

2. 2 Welcome/Goals Welcome Introduction of Team Members Goals of Meeting ● Discuss osteoporosis and low bone density ● Learn about the AOA Own the Bone Program ● Identify and Initiate Implementation Steps for Own the Bone

3. 3 Osteoporosis/Low Bone Density Magnitude of Problem ● 1 in 5 seniors who suffer a hip fracture die within 12 months, while another 20% end up in a nursing home ● Fragility is the most common cause of fractures among seniors, yet only 20% of patients receive best-practice care ● Up to 50% of all women and 25% of all men over age 50 will sustain fragility fractures in their remaining lifetime

4. 4 We are Taking the Lead We are now a participant of Own the Bone National Quality Improvement Program

5. 5 Why Did AOA Create Own the Bone? ● AOA Critical Issue: AOA understood it would take leadership to change physician and patient behavior ● AOA developed Own the Bone to address a treatment gap highlighted in the 2004 U.S. Surgeon General’s Report on Bone Health and Osteoporosis ● AOA successfully piloted Own the Bone in 14 hospitals in the United States for 10 months in 2005/2006 ● Results published in JBJS January 2008

6. 6 What is Own the Bone TM ? ● Web-based quality improvement initiative ● Multi-specialty approach ● Identify, evaluate and initiate evidence-based care for osteoporosis and low bone density after a fragility fracture in patients aged 50 and over ● OTB follows National Osteoporosis Foundation Clinician’s Guidelines ● Overlaps with CMS, AMA Physician’s Consortium, HEDIS Measures ● Consistent with Joint Commission Monograph on Osteoporosis

7. 7 Own the Bone: Goals ● Increase overall awareness and improve utilization of evidence- based management of osteoporosis and low bone density in fragility fracture patients 50 and over ● Change physician and patient behavior to reduce the incidence of future fractures and improve patient care by promoting bone health ● Encourage clinicians to identify, evaluate, diagnose, and treat patients with poor bone health after a fragility fracture ● Close the “treatment gap” documented in the RAND and NCQA studies ● Capitalize on the “Teachable Moment”

8. 8 Own the Bone: Benefits ● Promotes gathering and recording pertinent information efficiently through a National, Web based registry ● Allows downloadable library of patient education tools to assist compliance against 10 evidence-based measures ● Provides customized, system-generated letters to patients and physicians ● Benchmarking reports allows us to compare our results against the aggregate results of Own the Bone participants

9. 9 Own the Bone: Benefits ● Web-based training ● We need to schedule a date with AOA ● Exchange of best practices among participants through ongoing Webinars ● Some best practices are included in Getting Started binder and at www.ownthebone.org ● E-Newsletters ● System-generated patient and physician letters detailing the patient’s risk factors and recommendations for better bone health ● Public relations tools ● Press Release templates ● Special Own the Bone Participant Logo

10. 10 ● Demonstrating our leadership role regarding bone health ● Addressing the 82% treatment gap ● Proven QI program ready to implement ● Positive public relations ● It’s the right thing to do Why We Chose to Own the Bone Clear Commitment To Bone Health Demonstrated– Stop Future Bone Attacks!

11. 11 ● National Registry documents and measures participation ● “Failure to Diagnosis” osteoporosis and low bone density associated with related fractures is likely to become a key quality of care and professional liability issue for hospitals and physicians ● Joint Commission (JC)  Current efforts are underway to encourage JC to adopt measures from the JC’s Improving and Measuring Osteoporosis Management into the accreditation process Why We Chose to Own the Bone

12. 12 Nutrition Counseling ● Calcium ● Vitamin D Physical Activity Counseling ● Weight-bearing and muscle-strengthening exercise ● Fall prevention education Lifestyle Counseling ● Smoking Cessation ● Limiting excessive alcohol intake Pharmacology ● For the treatment of osteoporosis Testing ● Dual Energy X-Ray Absorptiometry (DXA) Communication ● Physician referral letter ● Follow-up note and educational material to patient The Program Measures Measures listed here are consistent with recommendations from the National Osteoporosis Foundation, the Centers for Medicare & Medicaid Services, the Joint Commission, the World Health Organization, and the American Medical Association.

13. 13 Simple, 2-Page Note Taking Form facilitates data management Own the Bone Note Taking Form

14. 14 Property of American Orthopaedic Association (AOA) Own the Bone Web-based Data Registry Simple, Web-based registry facilitates data management

15. 15 Property of American Orthopaedic Association (AOA) Own the Bone Web-based Data Registry Data registry login and id ● https://ownthebone.clinipace.org https://ownthebone.clinipace.org  User Name: XXXX  Password: XXXX  User Name: XXXX  Password: XXXX Own the Bone Web site login and id ● www.ownthebone/providers/subscriber www.ownthebone/providers/subscriber  User Name: XXXX  Password: XXXX ONE OR TWO?

16. 16 ● Collect data ● Enter and manage the data ● Provide patient education materials (downloadable from the registry) ● Communicate with Physician and Patient through system-generated letters ● Refer or schedule for DXA or pharmacotherapy, when indicated ● Follow up at 90 days (optional) Implementation

17. 17 Implementation Define trigger system to identify patients ● Who do we treat? ● Hip fracture patients? Other? Determine protocol to screen and treat patients ● Define lab panels ● Order osteoporosis consult ● Other Assign roles to team members

18. 18 Timeline Review Web site and program materials Define trigger system to identify patients Determine protocol to screen and treat patients Assign roles to team members Next meeting

19. 19 Next Steps/Goals for Next Meeting Review implementation plan Set milestones ● Date to start entering data ● Number of patients/time period ● Establish first data review date

20. 20 ● Getting Started Binder ● Program materials ● Best practices, and more ● Visit www.ownthebone.org or contact AOA at 847- 318-7336www.ownthebone.org ● Download materials to help explain Own the Bone ● FAQ’s ● Own the Bone Fact Sheet ● Description of System Generated Reports ● Training Webinar Resources

21. 21 AOA Contact Information: www.ownthebone.org ownthebone@aoassn.org Phone: 847.318.7336 Fax: 847.318.7339 AOA Own the Bone Team