CareConvoy provides real-world evidence of therapy effectiveness and contributes to lower readmission rates

MMS provides real-world evidence of therapy effectiveness and contributes to lower readmission rates

Duke Spine Center

Key Results

79%

Patients Experience 50%+ Pain Relief

77%

Patients Experience No Radicular Pain

50%

Hospital Readmissions

Introduction

1 FTE

Save Up to 1 Full-Time Employee

Various new Spine technologies have emerged in recent years, with limited data supporting their utility in a real-world setting. Prioritizing the collection of real-world evidence through patient-reported outcomes and evaluating treatment effectiveness is extremely important to surgeons and staff at premier spine centers. An efficient and automated tool that can track patient outcomes without putting an excessive burden on the staff has been a critical success factor. ACDFs and lumbar fusions were the two highest-volume spine surgeries targeted for the collection of this real-world evidence during a pilot of Manage My Surgery (MMS) at Duke Spine Center.

Challenges

  • High procedure volumes

  • Limited opportunity to educate and engage patients, often requiring investment in significant human capital

  • Limited availability to see patients at multiple post-operative visits to ensure good long-term outcomes

  • Lack of real-world evidence to support treatment efficacy of newer devices and products

Solution

In collaboration with the team at Duke Spine Center, the team at Higgs Boson built a clinically seamless workflow in Manage My Surgery to address the challenges noted above. The Manage My Surgery Spine Module also contains FAQs, notifications, and a variety of multimedia resources to educate patients on any questions they may have regarding the procedure.  Timed notifications that help guide the patient in the pre and post-op period, as well as calm the anxiety commonly encountered during such surgical procedures. Another feature that has been very well received by clinic staff is the ability to capture baseline and post-operative outcomes via the software platform, including:

  • Numerical Pain Assessment

  • PROMIS29

  • % Pain Reduction 

  • Back Disability Index

  • Neck Disability Index

MMS automatically sends patients a task at various time-points to gather data (task reminders are also set to go out in case the patient has not completed each survey). This has reduced the burden on the clinical staff to collect these outcomes manually and allowed for a consistent and predictable follow-up.  It has also allowed the identification of patients that may need attention sooner or that do not need to be seen, because they are doing well, further reducing the burden on the clinical staff and improving the efficiency of the clinical team.

Impact

107 patients (53 Lumbar Fusion and 54 ACDF) participated in the initial MMS Spine pilot. The protocolized workflow algorithm resulted in 79% of patients experiencing 50% or more overall pain relief. At long-term follow-up, 82% of ACDF patients reported 50% or greater improvement in their arm pain and 79% of ACDF patients reported a 50% or greater improvement in their neck pain.

At long-term follow-up, 77% of lumbar fusion patients reported no radicular pain and 75% of lumbar fusion patients reported a 50% or greater improvement in their back pain. 

 

300 patients (150 MMS members and 150 non-MMS members) participated in a second MMS Spine pilot. Patients that utilized MMS were found to have a 50% reduction in readmissions at 90 days (4% vs 8%).  This results in a cost savings of $200 per patient per month.  Patients that are more engaged in their care by using the MMS platform appear to have fewer hospital readmissions.

Spine surgery patients were also very satisfied with the utility of MMS: 95% of the pilot participants would recommend Manage My Surgery to a friend or family member.

Conclusion

MMS builds the real-world evidence base for Spine Centers and specific surgical devices in a scalable fashion. The results are presented in an easy, consistent, and standardized manner. MMS provides opportunities for further data analysis by combining patient-reported outcomes with data about the implanted hardware and surgical approach.  The MMS implementation at Duke Spine Center provides a useful virtual patient navigator that has improved the measurement of scalable patient-reported outcomes while saving staff effort, driving cost savings, and creating value.