Own the Bone New England Regional Symposium

By Marc F. Swiontkowski, MD

The Own the Bone New England Regional Symposium began with Symposium 7 of the AOA's 124^th Annual Meeting which provided an overview of both anabolic and anti-catabolic osteoporosis drug therapies, and their impact on fracture healing.  Andrew Bunta, MD then presented on the alarming statistics related to osteoporosis and fragility fractures and the need for systems-based interventions, such as Own the Bone. 

I moderated a panel discussion on how physicians implemented post-fracture systems-based quality improvement programs within their institutions.   Meryl LeBoff, MD began the discussion with an overview of Brigham and Women's Hospital post-fracture care program (B-FIT) and her research findings that extremely low vitamin D deficiency can lead to reduced muscle function, increasing the likelihood of falls in hip fracture patients. 

Eric D. Newman, MD shared his workflow for patients with low energy trauma fractures at the High Risk Osteoporosis Clinic (HiROC) within Geisinger Health System.  Each patient 50 and over with a low energy fracture receives a consult including treatment with vitamin D and calcium and patient education.  After discharge, patients are contacted to schedule another appointment, where labs are assessed, a DXA is scheduled and drug treatments are provided. 

William Macaulay, MD gave an overview of his Own the Bone program at NewYork-Presbyterian Hospital (NYPH) at Columbia.  Currently, a nurse practitioner identifies the fragility fracture inpatient and a patient educator (an occupational therapist) counsels the patient on their risk factors.  A research coordinator enters all patient data into the registry and makes the 90-day patient follow-up call.   

Kyle J. Jeray, MD presented on the Greenville Hospital System's Own the Bone program.  A reminder for staff is included in the EMR system to ensure that eligible patients are counseled and entered into the registry.  Patients are scheduled for a DXA before leaving the hospital and those in need of osteoporosis drug therapies are referred to a rheumatologist.  Greenville is working on additional pathways to ensure that outpatient fragility fracture patients are identified and counseled.

The discussion that followed emphasized the fact that each situation is unique to each local situation and that a clinical champion is an absolute requirement for success. OTB is a useful tool to put into the hands of the champion to provide a basic infrastructure to initiate a program.