HealthConnect, Kaiser Permanente’s electronic health record system in California, is in the process of formulating a new osteoporosis prevention program that could significantly drop cases of hip fractures in the nation by 25 percent.

Coined the world’s largest civilian EHR database, HealthConnect will assist the Kaiser initiative to gather data on patients including anti-osteoporosis medication use, bone density scans and fragility fractures

According to a study made by Kaiser Permanente, published in November at the Journal of Bone & Joint Surgery, offering active and early management of patients at risk for osteoporosis could reduce the hip fracture rate by 25 percent in the United States.  Researchers suggest it begins in the orthopedic surgeons’ more active participation in osteoporosis disease management. 

Considerably the largest effort to look at osteoporosis management in men and women over 50 years old, the study followed 650,000 men and women in Kaiser Permanente’s osteoporosis management program. Results show hip fractures dropped by 38 percent, significantly preventing 970 hip fractures from occurring in 2007. The study focused on the effectiveness of the Kaiser Permanente Southern California’s Healthy Bones Program from 2002 to 2007.

Recently, a new report shows that Kaiser Permanente is the leading effective osteoporosis disease management in the nation. The National Committee on Quality Assurance, a private organization aimed to improve the quality of healthcare, released recently the results of their Quality Compass study of reporting health plans for 2008.Out of 10 million Americans suffering from Osteoporosis, Women compromise 80 percent.

Lead author Richard M. Dell, MD, an orthopedic surgeon at Kaiser Permanente in Downey, California says, “Currently in the United States, the rate of treatment after a fragility fracture is only 20 percent. Treatment after a fragility fracture at Kaiser Permanente in Southern California is now 68 percent. Healthcare would be drastically improved if this model of osteoporosis care were adapted for the rest of America.”

Using the KP HealthConnect to identify people at risk for hip fractures, the Healthy Bones Program actively reaches out by providing them the bone density screenings and medications they need. The multidisciplinary team consists of various health professionals including: orthopedic surgeons and providers from endocrinology, family practice, internal medicine, rheumatology, gynecology, physical therapy, disease/care management, radiology and nursing education.

The study revealed that annual bone density screening rates increased from 21,557 scans in 2002 to 78,262 scans in 2007, marking a 263 percent increase from 2002 to 2007. During this time, people on anti-osteoporosis medications increased by 153 percent, from 33,208 to 84,155.

Dell believed that “The most important thing an orthopedic surgeon should know about osteoporosis/fracture prevention is that we can take action that helps to prevent hip and other fragility fractures. Simple steps like suggesting calcium and vitamin D for all your patients and bone mineral density testing in patients at higher risk for osteoporosis should be considered part of your daily practice.”

In the United States, more than 300,000 hip fractures are reported annually with 24 percent of them ending up in nursing home, 50 percent never reaching their functional capacity, and 25 percent die in the first year after the incident.