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Big Data, Biologics and Failure Rates Among Significant Interests for Surgeon

        Yates2 200x200
                  Dr. Adolph J. Yates

Adolph J. Yates Jr. is a graduate of Harvard College and completed his M.D., internship and residency at Johns Hopkins. He is an Associate Professor and the Vice Chairman for Quality Management within the UPMC Department of Orthopaedic Surgery. Dr. Yates is currently serving on the Surgical Committee for the National Quality Forum, as well as CMS technical expert panels involving PhysicianCompare, MACRA Measure Development and MACRA Cost Measures, and co-chairs the MACRA Episode of Cost Measure for Total Knee Arthroplasty for MACRA. His research interests include cartilage restoration, performance measures and patient access.

During the OMTEC keynote, you mentioned that health systems will soon use big data, system-specific registries and patient-reported outcomes data to make decisions. How is UPMC currently leveraging the myriad inputs of data?

Dr. Yates: In multiple ways. It is being used to best match patient needs, improve outcomes and better match resources.

Do you expect hospitals of all sizes and types to invest in similar information-gathering, on some level?

Dr. Yates: [It will be] very difficult at mid-size or smaller size institutions. The investment at UPMC is in the region of over a hundred million dollars, and not readily replicated. The answer for smaller hospitals will be outside vendors versus shared investment/information management.

How can orthopaedic device companies react?

Dr. Yates: The larger ones have already entered that environment as providers of data management; it is a value-added service/offering on top of the traditional markets and takes advantage of current relationships.

Also, during the keynote, you mentioned the use of biologics as the next paradigm jump in orthopaedics. In what ways do you expect biologics will change how you care for patients?

Dr. Yates: It will create more opportunities for younger patients. There will be a learning curve as to how late in life offering such an option is viable. It turns the discussion about arthroplasty and age upside down. At this time, there are no answers.

How far are we from this paradigm jump?

Dr. Yates: The old phrase comes to mind; “It is hard to make predictions, especially about the future." I will only be guessing, but common use in a decade.

What do engineers at orthopaedic device companies need to understand about surgeon quality and performance measures, and how the surgeons’ needs affect implant design?

Dr. Yates: There has never been a greater need for the lowest rates of failure possible. Proven devices with low revision rates might be seen as the safest bet compared to new technology/designs that have yet to be vetted in an after-market environment.

What’s the one hospital trend that orthopaedic device professionals need to watch?

Dr. Yates: Shared risk by surgeons and hospitals leading to greater standardization and expectations of discounts for volume. There will be increasing consolidation of which principal vendors are used as the surgeons reduce variability of choices in partnership with the hospitals.

What questions do you wish we’d asked? (What would you have said in response?)

Dr. Yates: Will direct to consumer marketing continue to give marginal advantage in sells? Response: Narrow networks and bundled payments will negate the utility of direct to consumer advertising. That marketing strategy worked better with surgeons at the margin responding to patient requests; the co-management trend of surgeons working with hospitals will make those marketing expenses less effective.

Julie Vetalice is ORTHOWORLD’s Editorial Assistant. She can be reached by email.