Becker's ASC Review

30 ORTHOPEDICS Top 10 orthopedic surgery residency programs By Patsy Newitt H ere are the top 10 orthopedic surgery residency programs, from Doximity's 2021-2022 Residency Navigator: 1. Hospital for Special Surgery/Cornell Medical Center (New York City) Size: 45 residents 2. Washington University (St. Louis) Size: 40 residents 3. Mayo Clinic College of Medicine and Science (Rochester, Minn.) Size: 65 residents 4. NYU Grossman School of Medicine/NYU Langone Orthopedic Hospital (New York City) Size: 70 residents 5. Duke University Hospital (Durham, N.C.) Size: 40 residents 6. University of Washington (Seattle) Size: 40 residents 7. Massachusetts General Hospital/ Brigham and Women's Hospital/ Harvard Medical School (Boston) Size: 60 residents 8. Rush University Medical Center (Chi- cago) Size: 25 residents 9. Vanderbilt University Medical Center (Nashville) Size: 25 residents 10. UPMC Medical Education (Pittsburgh) Size: 40 n How 4 spine practices are leveraging outcomes and payment data By Alan Condon Data that tracks patient satisfaction and clinical outcomes empowers physicians to objectively demonstrate care quality and value during payer and partner negotia- tions. Compiling information on what patients say about the care they receive allows practices to assess patients' satisfaction with their care, progress toward their goals and overall feelings about whether their health or condition has improved. Four spine surgeons outline how outcomes and payment data are collected and leveraged at their respective practices. Editor's note: e following responses were lightly edited for style and clarity. Question: How is your practice collecting/sharing clinical outcomes and payment data? Robert Bray Jr., MD. DISC Sports & Spine Center (Newport Beach, Calif.): At DISC, we collect data for all of our clinic and outpatient events done at the surgery center. We consolidate the billing records through HST and our medical records via DrChrono. We are developing new algorithms to loop the cost-effectiveness of the case on the quality assurance point of view. To do so, we link the decision making of the surgeon over time with the case selection and then review both the cost of that care and the clinical outcome via patient-derived data. is allows us to determine whether the medical care delivered is truly a cost-effective, patient- centered clinical decision. Michael Goldsmith, MD. e Centers for Advanced Orthopaedics (Bethesda, Md.): We collect clinical outcomes in a variety of ways for patients who are not in a particular study. For our surgical patients, we do routine preoperative assessments and follow these patients aer two, six and 12 weeks, and then again aer six and 12 months. We typically do a disability index with the Oswestry Disability Index, the SF-36 short form health survey and visual analog scales for pain. We have a robust electronic medical record system that enables us to collect this data. We have harmonized our EMR across all of our care centers so this data can be easily pooled and presented through our clinical subcommittees — specifically spine — to collate the information and share it amongst our physicians. In addition, I run a monthly [morbidity and mortality] conference to help identify and learn from any complications that may arise from surgery. Finally, we are involved on a state level in an initiative called Episode Quality Improvement Program that helps us follow our costs via payments through an episode-based approach. Brian Gantwerker, MD. e Craniospinal Center of Los Angeles: At this point, we are collecting our own outcomes data for its own sake. We are fully aware that payers at the end of the day are looking for any reason to pay you less, and really don't intend on paying more for good outcomes. We let our outcomes, patient satisfaction and reviews and patient-to-patient referrals be their own data and outcomes. Richard Kube, MD. Prairie Spine (Peoria, Ill.): Payments are easy as we have published cash prices online for several years. We have posters at our lobby entrance as well as rack cards at the counter. For outcomes, we assimilate data for never-event rates, clinical outcomes scores and the like. We post those items as well as patient satisfaction with our welcome packets and on our surgical suite website. COVID has us behind in some posting, but patients and payers have access to our numbers. n

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