A Foundation of Clinical Practice Guidelines
Back in 2007 when Academy attention was focused on ethics, industry relations and U.S. Department of Justice prosecutions, Weber was quietly at work on the Council of Research and Quality as clinical practice guidelines were being developed. She became Chair of that council a year later.
It wasn’t an easy sell at first.
Surgeons, especially those close to retirement, didn’t like being told what to do.
“I took a lot of hits for that,” said Weber in an interview on February 26, 2019.
“A lot of people didn’t like clinical practice guidelines. We could have communicated better, but they were an unbiased compilation of the evidence. Sometimes people don’t want to see what the evidence is if they have a set way of doing something.”
“That was over 10 years ago, and we’ve come a long way.”
“And now it’s no big deal when the Academy board approves the next clinical practice guidelines. There isn’t even much discussion. The work’s been done, and we approve it. It’s very different.”
“People understand that this is where medicine and orthopedics is going. We are expected to look at what works and what doesn’t to try to get some idea of how to take care of patients with the best potential outcome.”
“The younger generation is very much engaged in this. I think there is a generational gap of what people are happy about and what they’re not.”
“The Academy wants to help members survive in this shift to quality.” From filling out the boxes on applications for a bundled payment plan or MIPS [Merit-based Incentive Payment System Overview-QPP] scores to accessing the latest educational videos on cell phones.
She told us the Academy has to get people the actual data in a meaningful and personalized way. “There’s so much data and too much to keep up with.”
“We want to provide data at the point of care—digitally on your phone that’s been collated and developed by the Academy. We are moving to that. For instance, Ortho Guidelines is an app that allows appropriate use guidelines to be at the point of care.”
Reducing Reporting Burdens
We asked Weber about physician burnout which has accompanied the demand for collecting massive amounts of data and checking boxes for bundled payments and various alternate payments systems driven by Centers for Medicare and Medicaid Services (CMS) and followed by private payers.
She told us she spends “an immense amount of time” documenting things related to patients. “Seems like too many clicks for me. We have to do better. It’s been shown that if we don’t pay attention to the wellness of providers, patient care suffers. They are related.”
Matching performance measures with the Academy’s Registry efforts, which look at outcomes and safety issues related to implants, is “going to be huge.”
“This is the next iteration of the Academy’s quality vision, and I think it’s going to bring us more data that’s going to inform some of the other products we provide, whether it’s clinical practice guidelines or performance measures…we are going to be able to inform them through the data set.”
“If you participate in the Registry, you will be able to count that toward the requirements for CMS payment systems and for maintenance of certification (MOC).”
“Ideally, we want to be able to provide that feedback to providers, back to surgeons so they can continuously improve their practices. Our vision is that we will be able to reduce the reporting burden.”
