Orthopaedic Surgery and Evidence-based Patient Care: What’s the Value?

A short answer from Department of Orthopaedic Surgery Chairman Michael A. Mont, MD

What impact is evidence-based patient care having in the Department of Orthopaedic Surgery?

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Our department has established a reputation as a leader in maintaining comprehensive databases for patient demographic and outcomes data. These databases allow us to track outcomes on all of our patients and help us know how certain subtypes of patients are responding, what we are doing well, and how we can improve our care.

One of our most recent database project was initiated by Kurt Spindler, MD, who joined our staff in 2014 as Vice Chairman of Research, Orthopaedic & Rheumatologic Institute, and Director of Orthopaedic Clinical Outcomes. He had served as Principal Investigator of the NIH-funded Multicenter Orthopaedic Outcomes Network (MOON), which amassed data, and continues to do so, on thousands of joint replacement and arthroscopy procedures nationally. He understands that tracking patient data is the key to improving outcomes.

Dr. Spindler and others developed the OrthoMiDaS Episode of Care (OME) system, a secure web application that is HIPAA compliant, for our databases. Currently, we have entered data on more than 10,000 elective orthopaedic cases from both physicians and patients, including 98.5 percent of our hip, knee and shoulder replacements. We are now working on adding nonsurgical patients.

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Our databases have made it very easy to publish study results. More importantly, the data are fully validated, which makes the studies reliable. With close to 100 percent patient capture, it is not like we are drawing conclusions from only 80 percent of the patients without knowing what happened to the other 20 percent, which can be misleading.

Very soon, we will be able to provide robust one-year follow-up on all our hip and knee patients. We expect the findings—and those we obtain in the future—to have a tremendous impact on advancing medical care.

Michael A. Mont, MD
Chairman, Department of Orthopaedic Surgery
Cleveland Clinic

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