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Kevin Bozic, M.D., M.B.A., is passionate about improving orthopedic outcomes in ways that create a more sustainable healthcare system and firmly believes that value-based care should ultimately benefit the lives of the patients who seek solutions to debilitating health conditions.
Dr. Bozic, The Immediate Past President of the American Academy of Orthopaedic Surgeons (AAOS) and Chair of Surgery and Perioperative Care at the Dell Medical School at The University of Texas at Austin, has conducted extensive research and has policy experience in the field of value-based healthcare. He recently shared why transformative change in orthopedics should involve aligning the incentives of players throughout the industry and discussed ways in which emerging technologies and data registries can help drive value, contain costs and improve patient care.
Focusing on value is the key to effective and sustainable patient outcomes. How is value defined in healthcare?
Dr. Bozic: That’s frequently misunderstood. Michael Porter and Elizabeth Weisberg first introduced the concept in their 2006 book “Redefining Healthcare.” They proposed a framework for competition centered on value, which they defined as the outcomes important to patients and the cost associated with achieving those outcomes.
Consider the value comparison between buying a Starbucks coffee and making a cup at home. You must weigh what you receive against the cost and decide if it’s worthwhile. Value, therefore, is always determined from the customer’s perspective. Starbucks cannot dictate its value to you.
Similarly, outcomes in healthcare are defined from the patient’s viewpoint. In orthopedics, that means surgical outcomes are based on postoperative pain scores and functional status, which are assessed using patient-reported outcome measures — not just the results of medical tests or procedures.
How can value-driven care help drive innovation across the orthopedic industry?
Dr. Bozic: It’s an invaluable framework for fostering competition. Product development must focus on creating solutions that can compete in the market by delivering distinct outcomes at a reduced cost. That involves balancing two key factors: the outcomes crucial to patients and the overall expense involved in achieving those outcomes, which encompasses more than just implants or devices. Factors such as the care setting, postoperative lengths of stay and auxiliary equipment used during surgeries are equally important.
The concept of value in healthcare serves as a competitive blueprint. That’s particularly well-suited for the orthopedic device industry, which often finds itself competing on irrelevant grounds — such as relationships with surgeons or contracts with large health systems — none of which directly contribute to enhancing the value of effective patient care.
We’ve heard from OEM executives about the importance of innovating healthcare delivery models and rethinking how surgeries are performed instead of focusing solely on advancing surgical technologies. Do you agree with that mindset?
Dr. Bozic: I’d take an additional step back and emphasize the importance of a more effective disease management process. For instance, orthopedic companies are exploring various ways to manage joint arthritis to achieve optimal pain relief and functional status for patients.
Surgery of course represents one of these approaches. But we must also consider factors such as timely interventions, efficient surgical procedures, addressing pain management and minimizing risks of complications like postoperative infection when considering value across the spectrum of disease management.
Joint replacement is a salvage procedure that’s performed late in the disease process. So, ideally, we’d have upstream treatments available that eliminate the need for surgery. These considerations are essential to enhancing value and overall patient outcomes.
Value analysis committees at hospitals assess emerging devices in terms of cost savings and improved patient outcomes. How can orthopedic companies focus on those concerns to help bring new products to market?
Dr. Bozic: Having chaired a value analysis committee, the focus lies on assessing the value products offer to patients and determining the incremental cost associated with delivering that value. OEMs that can demonstrate incremental value to patient care could justify a higher price. Demonstrating the ability to deliver the same level of value and patient outcomes at a lower price point is another effective approach.
You’ve published research on the potential benefits and challenges of adopting generic implants. How could they add value to orthopedic care?
Dr. Bozic: From a technological perspective, there isn’t much difference between a branded implant and a generic one. Most of the components can be reverse-engineered. What sets branded and generic implants apart is the extensive service component that implant vendors offer their customers. If a generic manufacturer can develop an implant system that requires less on-site support, it could level the playing field. One approach could involve training facility-employed personnel, whether in an ASC or hospital, to provide the same level of support currently offered by implant companies. It’s this lack of customer support that has historically hindered the progress of generics.
The President’s Symposium you moderated at this year’s AAOS Annual Meeting focused on the emerging role artificial intelligence (AI) is playing in healthcare and was well-attended. How do you see the technology impacting the orthopedic industry?
Dr. Bozic: AI is in its early days. We’re witnessing an abundance of experimentation, yet few practical applications that instill confidence in users. Generative AI, for instance, is predominantly utilized in low-stakes scenarios because of its acknowledged potential for errors and misinformation. For tasks like drafting manuscripts, which undergo subsequent review and editing, the AI-associated risk is minimal. However, when AI is involved in processes that affect patient health, such as medical decisions or treatments, the stakes are considerably higher.
We expect the technology to evolve and become more accurate and reliable, particularly in standardizing disease management and improving access to universally applicable tools and pathways. The orthopedics industry appears to be exploring various applications without zeroing in on specific ones that significantly enhance patient outcomes. While there’s a lot of experimentation occurring in the technology’s applications, the tangible incremental value to patients remains limited. For now, AI is a hammer looking for a nail.
Data-driven care is also developing into a significant market driver in orthopedics. How will the reams of clinical data being collected today affect value-based care in the future?
Dr. Bozic: Generative AI platforms work on large language models. The AAOS patient registries are large language models and the more granular data we can add, the more valuable they are. AAOS registries have higher fidelity than other registries around the world because they are based on patient-reported outcomes measures (PROMs). Machine learning can analyze extensive PROMs and combine the information with patient demographic data and surgeon experience to predict which patients are most likely to benefit from surgery. That’s already being done.
Moving forward, improvements can be made in the percentage of patients who have clinical and demographic information captured before and after surgery. But based on sheer size alone, AAOS has access to more patient-reported outcome data than any other registry in the world.
This article originally appeared on BONEZONEpub.com.
Kevin Bozic, M.D., M.B.A., is passionate about improving orthopedic outcomes in ways that create a more sustainable healthcare system and firmly believes that value-based care should ultimately benefit the lives of the patients who seek solutions to debilitating health conditions.
Dr. Bozic, The Immediate Past President of the American Academy...
Kevin Bozic, M.D., M.B.A., is passionate about improving orthopedic outcomes in ways that create a more sustainable healthcare system and firmly believes that value-based care should ultimately benefit the lives of the patients who seek solutions to debilitating health conditions.
Dr. Bozic, The Immediate Past President of the American Academy of Orthopaedic Surgeons (AAOS) and Chair of Surgery and Perioperative Care at the Dell Medical School at The University of Texas at Austin, has conducted extensive research and has policy experience in the field of value-based healthcare. He recently shared why transformative change in orthopedics should involve aligning the incentives of players throughout the industry and discussed ways in which emerging technologies and data registries can help drive value, contain costs and improve patient care.
Focusing on value is the key to effective and sustainable patient outcomes. How is value defined in healthcare?
Dr. Bozic: That’s frequently misunderstood. Michael Porter and Elizabeth Weisberg first introduced the concept in their 2006 book “Redefining Healthcare.” They proposed a framework for competition centered on value, which they defined as the outcomes important to patients and the cost associated with achieving those outcomes.
Consider the value comparison between buying a Starbucks coffee and making a cup at home. You must weigh what you receive against the cost and decide if it’s worthwhile. Value, therefore, is always determined from the customer’s perspective. Starbucks cannot dictate its value to you.
Similarly, outcomes in healthcare are defined from the patient’s viewpoint. In orthopedics, that means surgical outcomes are based on postoperative pain scores and functional status, which are assessed using patient-reported outcome measures — not just the results of medical tests or procedures.
How can value-driven care help drive innovation across the orthopedic industry?
Dr. Bozic: It’s an invaluable framework for fostering competition. Product development must focus on creating solutions that can compete in the market by delivering distinct outcomes at a reduced cost. That involves balancing two key factors: the outcomes crucial to patients and the overall expense involved in achieving those outcomes, which encompasses more than just implants or devices. Factors such as the care setting, postoperative lengths of stay and auxiliary equipment used during surgeries are equally important.
The concept of value in healthcare serves as a competitive blueprint. That’s particularly well-suited for the orthopedic device industry, which often finds itself competing on irrelevant grounds — such as relationships with surgeons or contracts with large health systems — none of which directly contribute to enhancing the value of effective patient care.
We’ve heard from OEM executives about the importance of innovating healthcare delivery models and rethinking how surgeries are performed instead of focusing solely on advancing surgical technologies. Do you agree with that mindset?
Dr. Bozic: I’d take an additional step back and emphasize the importance of a more effective disease management process. For instance, orthopedic companies are exploring various ways to manage joint arthritis to achieve optimal pain relief and functional status for patients.
Surgery of course represents one of these approaches. But we must also consider factors such as timely interventions, efficient surgical procedures, addressing pain management and minimizing risks of complications like postoperative infection when considering value across the spectrum of disease management.
Joint replacement is a salvage procedure that’s performed late in the disease process. So, ideally, we’d have upstream treatments available that eliminate the need for surgery. These considerations are essential to enhancing value and overall patient outcomes.
Value analysis committees at hospitals assess emerging devices in terms of cost savings and improved patient outcomes. How can orthopedic companies focus on those concerns to help bring new products to market?
Dr. Bozic: Having chaired a value analysis committee, the focus lies on assessing the value products offer to patients and determining the incremental cost associated with delivering that value. OEMs that can demonstrate incremental value to patient care could justify a higher price. Demonstrating the ability to deliver the same level of value and patient outcomes at a lower price point is another effective approach.
You’ve published research on the potential benefits and challenges of adopting generic implants. How could they add value to orthopedic care?
Dr. Bozic: From a technological perspective, there isn’t much difference between a branded implant and a generic one. Most of the components can be reverse-engineered. What sets branded and generic implants apart is the extensive service component that implant vendors offer their customers. If a generic manufacturer can develop an implant system that requires less on-site support, it could level the playing field. One approach could involve training facility-employed personnel, whether in an ASC or hospital, to provide the same level of support currently offered by implant companies. It’s this lack of customer support that has historically hindered the progress of generics.
The President’s Symposium you moderated at this year’s AAOS Annual Meeting focused on the emerging role artificial intelligence (AI) is playing in healthcare and was well-attended. How do you see the technology impacting the orthopedic industry?
Dr. Bozic: AI is in its early days. We’re witnessing an abundance of experimentation, yet few practical applications that instill confidence in users. Generative AI, for instance, is predominantly utilized in low-stakes scenarios because of its acknowledged potential for errors and misinformation. For tasks like drafting manuscripts, which undergo subsequent review and editing, the AI-associated risk is minimal. However, when AI is involved in processes that affect patient health, such as medical decisions or treatments, the stakes are considerably higher.
We expect the technology to evolve and become more accurate and reliable, particularly in standardizing disease management and improving access to universally applicable tools and pathways. The orthopedics industry appears to be exploring various applications without zeroing in on specific ones that significantly enhance patient outcomes. While there’s a lot of experimentation occurring in the technology’s applications, the tangible incremental value to patients remains limited. For now, AI is a hammer looking for a nail.
Data-driven care is also developing into a significant market driver in orthopedics. How will the reams of clinical data being collected today affect value-based care in the future?
Dr. Bozic: Generative AI platforms work on large language models. The AAOS patient registries are large language models and the more granular data we can add, the more valuable they are. AAOS registries have higher fidelity than other registries around the world because they are based on patient-reported outcomes measures (PROMs). Machine learning can analyze extensive PROMs and combine the information with patient demographic data and surgeon experience to predict which patients are most likely to benefit from surgery. That’s already being done.
Moving forward, improvements can be made in the percentage of patients who have clinical and demographic information captured before and after surgery. But based on sheer size alone, AAOS has access to more patient-reported outcome data than any other registry in the world.
This article originally appeared on BONEZONEpub.com.
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Dan Cook is a senior editor with more than 18 years of experience in medical publishing and an extensive background in covering orthopedics and outpatient surgery. He joined ORTHOWORLD to develop content focused on important industry trends, top thought leaders and innovative technologies.
