UMMS study of patient-reported joint replacement outcomes cited for clinician-engaged learning

Patricia Franklin, MD, co-authored National Academy of Medicine paper featuring FORCE-TJR

By Sandra Gray

UMass Medical School Communications

March 13, 2017
  Patricia Franklin, MD, MBA, MPH
  Patricia Franklin, MD, MBA, MPH

UMass Medical School’s study of patient-reported outcomes following total joint replacement surgery embodies how front-line clinicians can be leaders in building continuously learning health care systems, according to a new discussion paper from the National Academy of Medicine.

“Our research is successful because of the engagement of patients and surgeons, and because it serves new knowledge and best clinical practice at the same time,” said Patricia Franklin, MD, MBA, MPH, co-author of the paper, which was released on March 6. “Patients are our partners, and our work prioritizes patient-reported outcomes.”

In 2013, the National Academy of Medicine (then the Institute of Medicine) presented a vision for a continuously learning health system to promote real-time improvement in the effectiveness and efficiency of care in the United States. A learning health care system links personal and population data to researchers and practitioners, dramatically enhancing the knowledge base on effectiveness of interventions and providing real-time guidance for superior care in treating and preventing illness.

In the new paper, Dr. Franklin, professor of orthopedics & physical rehabilitation, and co-authors discuss how actionable, timely and relevant knowledge generation depends on fully engaged clinicians, patients and health care data, and that leveraging the knowledge of front-line clinicians who interact with patients the most is essential to obtaining the best outcomes. FORCE-TJR is one of the three examples of programs they cite as meeting these objectives.

Franklin is principal investigator of FORCE-TJR, which stands for Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement. Funded with a $12 million grant from the federal Agency for Healthcare Research and Quality, the research program has built a database of more than 30,000 TJR patients since its launch in 2011, capturing how patients have fared physically and mentally since their surgeries. Findings from the most comprehensive national study of total hip and knee joint replacement patients and outcomes provide measureable patterns of patient pain, function, mobility and other health indicators that can help patients and their physicians understand where they fall on a national spectrum of pre- and post- joint replacement norms, and make treatment decisions accordingly.

With the rising numbers of Americans undergoing total joint replacement surgeries each year, the clinical research program showcases the reach and value of the continuously learning health system model.

“We developed streamlined procedures to ensure that busy real-world surgical practices could successfully submit complete data,” said Franklin. “The paper highlights our program as an example of how research and clinical care can co-exist and engage surgeons, who are using the data to improve quality in their day-to-day practice.”

Founded in 1970 as the Institute of Medicine and renamed in 2015, the highly regarded National Academy of Medicine aims to provide unbiased, evidence-based and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society and the public at large. The discussion paper was developed in collaboration with its Clinical Effectiveness Research Innovation Collaborative, which operates under the auspices of the academy’s Leadership Consortium for a Value and Science-Driven Health System. Read the full paper here.

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Data from UMMS-led registry shows national norms for timing of hip and knee replacements

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