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As a founding member of both the Council for Value in Spinal Care and the North American Spine Society's Value Task Force, Mayo Clinic orthopedic surgeon Bradford L. Currier, M.D., is committed to creating value in health care. As he sees it, the Division of Orthopedic Spine Surgery at Mayo Clinic is following 3 new paths that are especially promising for helping maximize value for patients:
Spine surgical suite at Saint Marys Hospital
Axial image of screw next to the femoral graft at L3
Surgical navigation system screen shot
The creation in 2009 of large, state-of-the-art spine operating rooms at Saint Marys Hospital makes it easier for large multidisciplinary teams of specialists to interact and take advantage of technological advances.
In particular, a new surgical navigation system and new intraoperative CT technology enable precise understanding of the anatomy in 3 dimensions with minimal access. Instrumentation can be placed and its location verified precisely.
"This technology is an exciting addition to our surgical armamentarium. Monitors linked to the surgical navigation system, cameras, and operating microscope allow everyone to see what's going on at all times," Dr. Currier says.
"This technology benefits patients undergoing minimally invasive surgery, but it has also proven useful for resecting tumors and creating complex osteotomies in deformity cases."
In addition to improved visualization, the new technology may promote faster recovery and shorter operating times because smaller incisions are needed.
Mayo Clinic's extensive total joint registry resources are being well leveraged to collect patient-reported outcome data. Mayo will use the data at the point of care to help understand the level of disability caused by the patient's condition and to monitor responses to treatment objectively. The data can also be used to assess the value — including cost-effectiveness — of various interventions in populations of patients.
Says orthopedic surgeon Paul M. Huddleston III, M.D., who leads the registry effort for the Division of Orthopedic Spine Surgery: "From a societal perspective, we need to rigorously assess the value of our care using methods that allow us to compare orthopedic interventions with those of other disciplines."
Data show that robust patient education improves patient satisfaction. A new Mayo initiative involves extending that finding beyond patient attitudes to treatment outcomes. Barbara K. Hanna, project manager for technology with Mayo Patient Education, is collaborating with the Department of Orthopedic Surgery on the project.
"We believe we can improve outcomes by taking a new approach to patient education," Hanna says. "Our research has found patient behavior does change with point-of-care instructional videos."
In the new approach, customized high-security software installed on the physician's consult room computer converts it into a secure information kiosk. The kiosk delivers to the patient educational information that is tailored to his or her condition.
"A better-informed patient can participate in shared decision making and become a partner rather than a passive recipient of care," Dr. Currier says. "We believe there is real value in leveraging new technology to improve patient understanding, safety, and outcomes in a cost-effective manner."
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