Implementing a fracture liaison service open model of care utilizing a cloud-based tool

S. L. Greenspan, A. Singer, K. Vujevich, B. Marchand, D. A. Thompson, Y. J. Hsu, D. Vaidya, L. S. Stern, D. Zeldow, D. B. Lee, S. Karp, Robert R. Recker

Research output: Contribution to journalArticle

Abstract

Purpose: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. Methods: The pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool. Results: Ninety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS. Conclusions: We conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalOsteoporosis International
DOIs
StateAccepted/In press - Feb 10 2018

Fingerprint

Vitamin D
Osteoporotic Fractures
Delivery of Health Care
Secondary Prevention
Bone Density
Calcium
Therapeutics
Quality Improvement
Osteoporosis
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism

Cite this

Greenspan, S. L., Singer, A., Vujevich, K., Marchand, B., Thompson, D. A., Hsu, Y. J., ... Recker, R. R. (Accepted/In press). Implementing a fracture liaison service open model of care utilizing a cloud-based tool. Osteoporosis International, 1-8. https://doi.org/10.1007/s00198-017-4371-y

Implementing a fracture liaison service open model of care utilizing a cloud-based tool. / Greenspan, S. L.; Singer, A.; Vujevich, K.; Marchand, B.; Thompson, D. A.; Hsu, Y. J.; Vaidya, D.; Stern, L. S.; Zeldow, D.; Lee, D. B.; Karp, S.; Recker, Robert R.

In: Osteoporosis International, 10.02.2018, p. 1-8.

Research output: Contribution to journalArticle

Greenspan, SL, Singer, A, Vujevich, K, Marchand, B, Thompson, DA, Hsu, YJ, Vaidya, D, Stern, LS, Zeldow, D, Lee, DB, Karp, S & Recker, RR 2018, 'Implementing a fracture liaison service open model of care utilizing a cloud-based tool', Osteoporosis International, pp. 1-8. https://doi.org/10.1007/s00198-017-4371-y
Greenspan, S. L. ; Singer, A. ; Vujevich, K. ; Marchand, B. ; Thompson, D. A. ; Hsu, Y. J. ; Vaidya, D. ; Stern, L. S. ; Zeldow, D. ; Lee, D. B. ; Karp, S. ; Recker, Robert R. / Implementing a fracture liaison service open model of care utilizing a cloud-based tool. In: Osteoporosis International. 2018 ; pp. 1-8.
@article{12bdfbbf51f140e1837b240eeb7bf43b,
title = "Implementing a fracture liaison service open model of care utilizing a cloud-based tool",
abstract = "Purpose: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. Methods: The pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool. Results: Ninety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21{\%} at baseline to 93{\%} (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84{\%} (p < 0.001). Patients prescribed calcium/vitamin D increased from 36{\%} at baseline to 93{\%} (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54{\%} (p < 0.001) Post FLS. Conclusions: We conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.",
author = "Greenspan, {S. L.} and A. Singer and K. Vujevich and B. Marchand and Thompson, {D. A.} and Hsu, {Y. J.} and D. Vaidya and Stern, {L. S.} and D. Zeldow and Lee, {D. B.} and S. Karp and Recker, {Robert R.}",
year = "2018",
month = "2",
day = "10",
doi = "10.1007/s00198-017-4371-y",
language = "English (US)",
pages = "1--8",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",

}

TY - JOUR

T1 - Implementing a fracture liaison service open model of care utilizing a cloud-based tool

AU - Greenspan, S. L.

AU - Singer, A.

AU - Vujevich, K.

AU - Marchand, B.

AU - Thompson, D. A.

AU - Hsu, Y. J.

AU - Vaidya, D.

AU - Stern, L. S.

AU - Zeldow, D.

AU - Lee, D. B.

AU - Karp, S.

AU - Recker, Robert R.

PY - 2018/2/10

Y1 - 2018/2/10

N2 - Purpose: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. Methods: The pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool. Results: Ninety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS. Conclusions: We conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.

AB - Purpose: Although half of women and one-quarter of men aged 50 and older will sustain an acute low-trauma fracture, less than a quarter receive appropriate secondary fracture prevention. The goal of this quality improvement demonstration project was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in three open health care systems aided by a cloud-based tool. Methods: The pre–post study design examined the proportion of men and women over age 50 who received appropriate assessment (bone mineral density, vitamin D levels) and treatment (calcium/vitamin D, pharmacologic therapy) in the six months following a recently diagnosed fracture. The pre-study (Pre FLS) included a retrospective chart review for baseline data (N = 344 patients) within each health care system. In the post-evaluation (Post FLS, N = 148 patients), the FLS coordinator from each health care system examined these parameters following enrollment and for 6 months following the recently diagnosed fracture. Data were managed in the cloud-based FLS application tool. Results: Ninety-three participants completed the program. The FLS program increased the percentage of patients receiving bone mineral density testing from 21% at baseline to 93% (p < 0.001) Post FLS implementation. Assessments of vitamin D levels increased from 25 to 84% (p < 0.001). Patients prescribed calcium/vitamin D increased from 36% at baseline to 93% (p < 0.001) and those prescribed pharmacologic treatment for osteoporosis increased on average from 20 to 54% (p < 0.001) Post FLS. Conclusions: We conclude that the FLS model of care in an open health care system, assisted by a cloud-based tool, significantly improved assessment and/or treatment of patients with a recently diagnosed osteoporotic fracture. Future studies are necessary to determine if this model of care is scalable and if such programs result in prevention of fractures. Mini-Abstract: The goal was to implement a Fracture Liaison Service (FLS) focused on secondary prevention of an osteoporotic fracture in open health care systems aided by a cloud-based tool. This model significantly improved assessment and/or treatment of patients with a recently diagnosed fracture.

UR - http://www.scopus.com/inward/record.url?scp=85041904660&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041904660&partnerID=8YFLogxK

U2 - 10.1007/s00198-017-4371-y

DO - 10.1007/s00198-017-4371-y

M3 - Article

SP - 1

EP - 8

JO - Osteoporosis International

JF - Osteoporosis International

SN - 0937-941X

ER -