New tool may encourage doctors’ visits among high-risk osteoporosis patients

Orthopedic physicians should always be on the lookout for new advances in health care technology that may help their practices run more smoothly or benefit their patients. For example, electronic health record systems that are designed for orthopedic practices may help streamline physicians' workflows. Furthermore, according to a recent study conducted by researchers from Penn State College of Medicine, a new automated system designed to help orthopedic patients who have experienced fractures may help prevent them from experiencing more fractures

The researchers created a system that could identify high-risk osteoporosis patients who were currently being treated for fractures, and then send them letters encouraging them to follow up with a physician because they were at risk for the bone health condition. The scientists identified patients who were at least 50 years old and were being treated at the emergency department of Penn State Milton S. Hershey Medical Center for fractures. Next, the researchers examined the patients' treatment codes to determine which ones had fractures caused by bone fragility, of which there were about 103. In order to identify these patients, the researchers were given monthly data from the hospital that allowed them to create a spreadsheet to screen for osteoporosis. Once patients were added to that spreadsheet, the database went through their cases again to remove patients who had falls that did not seem to be associated with fragile bones. 

When researchers had the final list of patients who had experienced fractures and had a high risk of osteoporosis, letters were generated and sent to these individuals. The letters explained that they may be at risk of developing osteoporosis and should schedule a visit to their doctor. Three months later, phone calls were made to determine if patients had ever made these appointments. 

"Our almost fully automated osteoporosis system identifies these patients, requires minimal resources — many of which are already currently in U.S. hospitals, but just need to be tapped — and delivers substantially improved osteoporosis intervention results," said Edward Fox, professor of orthopedics at Penn State. 

The researchers compared the individuals who had received letters to 98 other patients who had not. They discovered that 60 percent of patients who had received the letter had made follow up appointments with doctors, while only 14 percent of those who did not get letters made appointments. 

"Progressive bone fragility leads to greater risk for fractures," Fox said. "Hospitals treat fragility fractures, but they have no system in place to evaluate those same patients for osteoporosis to prevent the next fracture. This study's results are better than no letter or doing nothing, which is what most hospitals are doing, including the one piloting our program before it started this program."

Osteoporosis screening has limitations
The goal of this study was to identify people who are at a high risk for osteoporosis and encourage them to seek treatment. This is particularly important considering that The Houston Chronicle health blog recently reported that a study from the University of California, Los Angeles, has found that the osteoporosis screening methods recommended by the United States Preventive Services Task Force for women between the ages of 50 and 64 may only catch 34 percent of women in this age range who may have osteoporosis. The researchers explained this strategy may be causing health care providers to miss chances to try to prevent fractures among women who may have osteoporosis. 

 This suggests that more screening methods may be needed to make sure that everyone who is at risk of osteoporosis is given the proper treatment and information for how to prevent fractures.