31.07.2019

Improving pathways in elective orthopaedic surgery

heartbeat participates in government funded study to prove cost-effectiveness and better out-patient care with PROMs.

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The Federal Joint Committee’s Innovation Fund

In Germany, the Care Provision Strengthening Act of 2015 aimed to safeguard the ongoing supply and development of high quality medical care that is easily accessible to all. The Federal Joint Committee comes under this act and holds the highest decision making power in the self-governing German healthcare system. Moreover, this Committee is responsible for the promotion of innovative healthcare advancement projects to benefit patients and their health. Through the Innovation Fund, 225 million euros are dedicated to the promotion of new forms of care along with 75 million euros for the promotion of health services and so our tale of innovation and collaboration begins…

PROMoting Quality

PROMoting Quality is a collaborative research project involving all stakeholders in the healthcare value chain. The goal is that through working together we can investigate the use of Patient Reported Outcome Measures (PROMs) for cost effectiveness and for the early detection of post-surgical complications. The study will be a multi-centre, randomised intervention with economic evaluation. 

Digital Patient Reported Outcomes (PROs) are designed to facilitate early follow-up and thus close the gap between inpatient acute and outpatient follow-up care. As part of the PROMoting Quality research initiative, PROMs will be used to assess the course of treatment for knee and hip prostheses during the course of this project. The project is privileged to have the support of 3.5 million euros from the Innovation Fund. 

Early identification of post-operative complications using PROs

PROMoting Quality, which was launched in April of this year, believes that through the digital collection of PROs following knee and hip joint replacement surgery, early postoperative complications can be identified. Timely initiation of follow-up treatment should increase patient success and cost-effectiveness of treatments for insurers.

An area-wide, standardised and cross-sector assessment of the success of a therapeutic intervention from the patient’s perspective does not currently exist. Thus, the project aspires to close the care gap between the acute in-patient and out-patient through heartbeat’s accredited PROMs sets to track the patient’s health progress. 

Without timely and standardised information about symptoms, e.g. the impairment of the patient’s quality of life, doctors can not take steps to address the problems underlying the symptoms. Often the attending specialist only learns about post-surgical problems and complications in an advanced stage, which is why measures are delayed and may not be implemented a further inpatient stay becomes necessary. Herein, we have our research niche! 

The measurement of PROs and the corresponding healthcare costs corresponds to the value-based healthcare concept perfectly. Value-based healthcare is a healthcare delivery model whereby providers, including hospitals and physicians, are paid based on patient health outcomes rather than by patient volume. It is a value-based medicine that focuses on improving endpoints that are relevant to the patient, such as reducing pain or increasing mobility.

Pillars of the initiative: leading endoprosthetics clinics and major health insurances

Under the direction of the TU Berlin, heartbeat are working with eight specialised clinics with a focus on endoprosthetics throughout Germany, along with the health insurers BARMER, the BKK umbrella organization and the aQua institute. As a consortium partner, heartbeat ensures the implementation of the study through the digital recording of Patient Reported Outcomes. The recorded PROs are available in real time. They enable the clinics to recognise obstacles in the healing and recovery processes and to initiate appropriate aftercare.

The involved clinics are:

10,000 patients forecast with planned hip or knee replacements

From October of this year, 10,000 patients with a planned hip or knee replacement will be included in the study. The patients included will be randomly assigned to an intervention and a control group. Whilst the control group is interviewed for in-patient treatment with a one-year treatment follow up via heartbeat;s PROMs collecting platform, the intervention group participates in questionnaires at intervals of one, three, six and twelve months after the end of treatment. The project, including patient recruitment and data analytics is predicted to be completed within four years. 

We at heartbeat are enthusiastic that this multidisciplinary research initiative will lead to informative healthcare advancements that will benefit patients and payers by placing them at the heart of their care!

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Written by
Yannik Schreckenberger

Co-founder & CEO of heartbeat, former Hacking Health Berlin lead organiser, physicist and tech enthusiast.

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