They often have multiple doctors manage their own care and can be more susceptible to complications. And for as many doctors and other care professionals the care coordination is inadequate. Why? Because many established practices set out on a business model that requires them to see more patients faster. These practices have every right to operate that way, but the patient is the one that is underserved in many cases. Sometimes, patients simply need more than three minutes with their healthcare provider. But the provider doesn’t have more time to offer.
We’ve structured our practice differently from the beginning. While orthopaedics is considered a “specialty” and not “primary care,” the orthopaedic practice “becomes” the primary focal point of their osteoarthritis care. Moreover, in the case of a joint replacement surgery, the orthopedic surgeon transitions into the role of primary focal point for the period of time both before and after the surgery, for a full year.
Care coordination with all the other providers is paramount
You may have heard the term “value-based care” in the news, and in marketing and advertising materials. This term means many things to many people.
It encompasses medical history analysis
Comprehensive care planning and health management to keep you out of the hospital using a more organized and holistic model.
It integrates “patient engagement” (in other words, taking the patient by the hand to help them take better care of themselves and be more involved as their own advocate.)
It involves the Internet of Things and remote patient monitoring.
It involves not having to “go” someplace for a blood pressure measurement, an oxygen measurement, a weigh in, or some other biometric measurement that could be done at home without a copay for an office visit
It involves coordinating your prescriptions to make sure you’re not being overprescribed by all your doctors and providers
Care coordination makes surgical and recovery and rehabilitation planning more thorough
Costs are reduced for the Medicare and Medicare Advantage programs, and for patients and for healthcare providers facing clinical staff shortages
Schedules and responsibilities of our staff are better managed leading to better appointment availability and quicker access to surgery
Doing some services from home and not having to come into the office for a visit cuts down on patient travel risk, costs of fuel and fuel consumption and lower infection risks. It’s also more convenient.
When you join our program, the first thing we do is a get acquainted meeting to gather information about your orthopaedic and other medical conditions.
A detailed medical history is essential in orthopaedic treatment because it provides valuable information about a patient’s health status, previous injuries, surgeries, and medications that can impact their orthopaedic care. A thorough medical history can help orthopaedic surgeons make more informed decisions about a patient’s treatment plan, reducing the risk of complications and improving outcomes.
Orthopaedic conditions can be complex, and many other (non-orthopaedic) factors can impact a patient’s recovery and rehabilitation. A detailed medical history helps us to identify any medical conditions or medications that may increase the risks of complications, confusion or falls before or after surgery or during rehabilitation that could set you back or injure you further.
For example, patients with diabetes, hypertension, or heart disease may require additional monitoring and precautions during surgery and rehabilitation to reduce their risk of complications. They may be at risk for wound healing complications because sugars feed bacteria.
Depressive disorders can also complicate recovery. We address these with compassion and extra support, when necessary.
Excess weight tends to impact your joints at the rate of 4 pounds of pressure on the joints for every extra 1 pound you carry. We can refer you to specialists or for weight loss surgery, or to a nutritionist or dietitian. But we are also limited by body mass index (BMI) scores, in that we generally cannot perform surgery with a BMI in excess of 40 without extremely compelling reasons.
Previous surgeries, injuries and treatments. A detailed medical history can help identify any previous orthopaedic injuries or surgeries that may impact one’s current condition. Understanding previous injuries or surgeries can help our surgeons and PA to develop a more targeted treatment plan, including appropriate rehabilitation and low-opioid, multi-modal pain management strategies.
A thorough medical history can help identify any medications and supplements that may impact your orthopaedic care. For example, some medications, such as blood thinners, can increase the risk of bleeding during surgery or delay healing after surgery. Other medications don’t play well with others and could pose dangerous conflicts if we don’t know what other physicians and practitioners have prescribed, or supplements you may have decided to add independently of their counsel.
A detailed medical history helps us learn about your health and wellness goals and gain insight into one’s lifestyle and habits, such as their occupation, hobbies, and physical activity level. Understanding these factors can help your coaching team develop a more personalized treatment plan that takes into account your unique needs and goals. For example, a patient with a physically demanding job or hobby or sport may require a more aggressive rehabilitation plan to return to work quickly.
A detailed medical history helps establish a better quality connection between the patient and healthcare providers. When we take time to listen to your history and concerns, you come to trust us with your care and refer your friends and family for care because of how we take care of you.
Neurocognitive testing is an essential tool in the assessment and management of our orthopaedic patients. Our Concierge Orthopaedic program for patients with osteoarthritis and other chronic conditions is a comprehensive approach to healthcare for patients with chronic conditions, such as diabetes, heart disease, hypertension, asthma, balance and chronic pain, and dementia. These conditions require continuous monitoring, management, and support to ensure patients receive the best possible care. Neurocognitive testing is a valuable component of this care because it can provide information about a patient’s cognitive functioning, which can be essential in managing their care.
Neurocognitive testing involves the assessment of various cognitive domains, such as memory, attention, language, executive function, and spatial reasoning. Neurocognitive testing is essential in planning orthopaedic surgery because it can help identify any cognitive deficits that may impact a patient’s ability to undergo and recover from surgery successfully. Medicare pays us a small amount based on the time needed. We plan for the extra time necessary with each patient without feeling stressed about lower reimbursements. While other doctors rush and complain about reimbursements, that’s not how we roll. We’re grateful you’ve selected us to care for you and your family. And if there’s no additional time taken in a month, Medicare doesn’t get a bill. This is the only program of its kind in orthopaedics from the Mexican border to the Canadian border.
Orthopaedic surgery involves balance, concentration, and coordination of mobility and movement that require patients to be alert, oriented, and capable of following postoperative instructions. Patients with cognitive deficits may have difficulty adhering to these instructions, which can lead to poor surgical outcomes and an increased risk of falls and other serious complications.
Our program includes neurocognitive testing (the assessment of memory, attention, language, executive function (balance, coordination, and motor planning), and spatial reasoning and fine motor coordination. These tests were chosen to help identify any cognitive deficits that may impact one’s ability to undergo surgery and recover successfully. For example, patients with cognitive deficits related to attention and memory may have difficulty following postoperative instructions, managing pain medication, or driving to and attending follow-up appointments and physiotherapy.
In addition, neurocognitive testing can help identify any underlying cognitive impairments that may be contributing to a patient’s orthopaedic condition.
For example:
Our Concierge Orthopaedics Program for patients with osteoarthritis and other chronic conditions includes a remote patient monitoring (RPM) feature . RPM is a technology-based approach that allows our clinicians to remotely monitor your health status and condition outside of traditional healthcare settings in our clinic.
In orthopaedics, RPM can be used to monitor patients’ progress, recovery, health status of other conditions that impact your rehabilitation progress following surgery or injury. We use various technological devices, such as wearable sensors, mobile applications, and telehealth platforms, to monitor patients’ health status remotely. you may have heard these referred to as the Internet of Things (IoT).
These amazing devices can track various metrics, such as range of motion, weight, oxygen intake while awake and asleep, blood pressure, blood sugar levels, strength, pain, and functional status, which can provide valuable information about you recovery and rehabilitation progress.
In orthopaedics, RPM can be used in several ways, including:
Pre- and Post-surgical monitoring: Before and after orthopaedic surgery, RPM can be used to remotely monitor patients’ recovery progress, including wound healing, pain management, and mobility. This can allow healthcare providers to identify any potential complications or issues that may require intervention.
Rehabilitation monitoring: RPM can be used to remotely monitor patients’ rehabilitation progress, including range of motion, strength, and functional status and exercise frequency. This can allow us and your therapist to track your progress and adjust your rehabilitation plan, as needed, even if you cannot travel to the clinic for physical therapy from a faraway place.
Chronic condition monitoring: For our patients with chronic orthopaedic conditions, RPM can be used to monitor your condition remotely, including pain levels, blood sugar, blood pressure, oxygen intake, medication adherence, and functional status. This can allow us to identify any changes in your condition and adjust your treatment plan as needed.
Virtual physical therapy: We work with physical therapists who offer virtual physical therapy sessions to patients, allowing them to participate in rehabilitation exercises from home. This can be particularly useful for our patients who have limited mobility or live in remote areas of Utah, Arizona, Nevada, Idaho, Wyoming, Colorado, New Mexico, and California.
The benefits of RPM in orthopaedics are numerous. By providing remote monitoring and support, RPM can help improve patient outcomes, reduce healthcare costs, and enhance patient satisfaction. By tracking patients’ recovery and rehabilitation progress remotely, healthcare providers can intervene earlier if complications arise, potentially reducing the need for hospital readmissions or emergency room visits. Additionally, RPM can provide patients with greater flexibility and convenience, allowing them to receive care from the comfort of their own homes. And what’s amazing is that if you have these other conditions that require an IoT RPM monitoring technology, Medicare pays the monthly fee for the equipment you’ll need.
By providing patients with remote monitoring and support, healthcare providers can improve patient outcomes, reduce healthcare costs, and enhance patient satisfaction.
Our Concierge Orthopaedics Program for patients with osteoarthritis and other chronic conditions coupled with an annual wellness visits (AWVs) are important tools in the recovery and wellness of patients with orthopaedic problems.
Orthopaedic conditions, such as arthritis, neck, back, hip, shoulder, and knee pain, and acute joint injuries, can have a significant impact on a patient’s quality of life, and require ongoing management and support to ensure optimal recovery and wellness.
The approach we take in our Concierge Orthopaedics Program involves a comprehensive 360° approach to healthcare for patients with chronic conditions. We deliver comprehensive care, including regular monitoring, management, and around-the-clock telehealth and in-person support to ensure our program participants receive the best possible care, coaching and support.
The benefits of this program include:
Improved outcomes: Our Concierge Orthopaedics Program can improve outcomes for patients with orthopaedic problems by providing ongoing support and management, in person and via telehealth and remote support. This can help patients better manage their condition, reduce the risk of complications, and improve their overall quality of life.
Tailored wellness and recovery plans: Our Concierge Orthopaedics Program involves developing tailored treatment plans that take into account one’s unique needs and wellness, activity and lifestyle goals. This can help our patients receive care that is specific to their condition, improving the effectiveness of treatment.
Coordinated care: Our Concierge Orthopaedics Program involves coordinating care between our clinic and healthcare providers, including primary care physicians, other specialists, clinical pharmacists, pain management, and physical therapists. This can help ensure patients receive comprehensive care that addresses all aspects of all their conditions.
Annual wellness visits (AWVs) are another important tool in the recovery and wellness of patients with orthopaedic problems. These visits are comprehensive discussions and health planning to focus on preventive care, including screenings, vaccinations, and counseling on healthy lifestyle habits for the year ahead. Medicare pays for this as an extra benefit you may be unaware of.
The benefits of annual wellness visits for orthopaedic problems include:
Early detection of potential problems: Annual wellness visits can help detect potential orthopaedic problems early, before they become more serious. This can allow for earlier intervention and treatment, improving outcomes for patients.
Preventive care: Annual wellness visits focus on preventive care, including screenings for conditions that can impact orthopaedic health, such as osteoporosis and other types of arthritis and painful conditions. This can help prevent or delay the onset of orthopaedic problems and the need for surgery.
Counseling on healthy lifestyle habits: Annual wellness visits provide an opportunity for healthcare providers to counsel patients on healthy lifestyle habits that can improve their orthopaedic health, such as exercise and weight management that add extra impact on bones and joints.
By providing ongoing support, tailored treatment plans, and preventive care, these approaches can improve outcomes, prevent complications, and enhance quality of life for patients we can better plan for wellness and fulfilling active lifestyles our patients want to achieve and maintain.
In collaboration with our consulting clinical pharmacists, patients who are enrolled in our Concierge Orthopaedic Program may occasionally be referred to our consulting clinical pharmacists for Medication Therapy Management (MTM) services. These services are provided by clinical pharmacists and have been recognized as a valuable benefit under Medicare.
These services aim to optimize medication use, improve medication adherence, and prevent adverse drug events in patients with complex medication regimens. Medicare recognizes the importance of MTM services in improving patient outcomes and reducing healthcare costs, which is why it has included it as a benefit for eligible patients.
MTM services provided by clinical pharmacists include comprehensive medication reviews, medication therapy recommendations, and medication management services. These services aim to help patients achieve their therapeutic goals, identify and resolve medication-related problems, and promote medication safety. Clinical pharmacists work collaboratively with patients and their healthcare providers to ensure medication therapy is safe, effective, and appropriate for the patient’s health status and medical history.
Under Medicare Part D, eligible patients are entitled to receive MTM services from a qualified clinical pharmacist. To be eligible, patients must have multiple chronic conditions, take multiple medications, and have an annual prescription drug cost that exceeds a certain threshold. If we determine you meet these criteria, we make the referral with your express approval and schedule the appointment for you.
What’s involved?
During a medication review, the clinical pharmacist reviews the patient’s medication regimen, including prescription medications, over-the-counter medications, and dietary supplements. They assess the appropriateness of each medication, evaluate for potential drug interactions, and identify any medication-related problems or the risk of conflicting substances. The pharmacist then works with our practitioners to develop a comprehensive medication management plan, which includes recommendations for optimizing medication therapy, eliminating duplication of medication classes, substances to which you may be allergic, and helping you more easily adhere to medication instructions.
The benefits of MTM services provided by clinical pharmacists are numerous. They can help improve patient outcomes, reduce healthcare costs, and enhance patient satisfaction. By optimizing medication use and promoting medication adherence, patients are less likely to experience medication-related problems and adverse drug events, which can reduce hospitalizations and emergency room visits. Additionally, patients who receive MTM services report higher levels of medication adherence, improved quality of life, and greater satisfaction with their medication regimen.
In conclusion, MTM services provided by clinical pharmacists are an important Medicare benefit for eligible patients. These services aim to optimize medication use, improve medication adherence, and prevent adverse drug events in patients with complex medication regimens. By working collaboratively with patients and their healthcare providers, clinical pharmacists can help improve patient outcomes, reduce healthcare costs, and enhance patient satisfaction. As such, it is important for healthcare providers to incorporate MTM services into their treatment plans for eligible patients to ensure they receive the best possible care.
Traditional Medicare with a supplemental policy or Medicare Advantage plans pay the costs of the program and the bluetooth equipment, if necessary. Medicare is willing to pay because it saves Medicare millions of dollars each year by not paying for hospitalization or duplicate and/or unnecessary prescription medications.
Robotic Orthopaedic Institute St George, LLC
1490 East Foremaster Drive, Ste 260
St George, UT 84790
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