What's the next game changer in orthopedics? 5 surgeon insights


When thinking about the next five years in orthopedics and the biggest game changers in the field, some surgeons say evolving technology and payer models stand out.

Five surgeons told Becker's why they believe tech and payer models will become more prominent.

Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting orthopedic care. We invite all orthopedic surgeon and specialist responses.

Next week's question: How do you see orthopedic care delivery evolving in the next five years?

Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Wednesday, Oct. 20.

Note: Responses were edited for style.

Question: What do you see as the next true game changer in orthopedics?

Ammar Saymeh, DPM. NJ Spine and Wellness (Freehold): The next true game changer is the evolution of robotics in mainstream orthopedics. We have already seen it become a prominent aspect in some areas of orthopedics. As technology continues to improve, robotics will be a mainstay within various subspecialties in the field. There will be less room for human error in the future. The accuracy in which certain hardware is placed will improve overall long-term outcomes for the patients — for example, the angles at which an artificial joint component would be placed perfectly as a result of precision measurements and assessments by the use of robotic systems. This will also relieve the need for future revisions and lower the overall burden on the health care system. It will also improve surgical workflow and reduce operating room times. Robotics within orthopedic surgery will change and improve the landscape for patients and providers alike.

Navin Subramanian, MD. Orthopaedic Associates (Houston): This is a loaded question with numerous options. The field of orthopedics is vast and encompasses many pathways. When I take the spectrum of orthopedics in total, I think the biggest game changer in orthopedics will be a move to bundled payment systems to deliver care for surgical procedures. There will be an ongoing larger shift to more outpatient procedures and larger shift to risk-sharing payment systems. This will affect quality of care and may even affect access to care. Risk-sharing models may make surgeons reconsider performing otherwise routine procedures on patients with higher risk stratification. The bundled payment systems may lead payers to either partner with facilities or with physicians; this may influence hospital employment versus private practice models for orthopaedic surgeons. It will be interesting to see how this plays out over the next few years.

Jason Snibbe, MD. Snibbe Orthopedics (Los Angeles): The next game-changer in orthopedics will be artificial intelligence. When a patient comes into the office, we will be able to use software with voice and face recognition.This will allow patients to have paperless and touchless access in the office. It will also allow us to create algorithms for treatment protocols. It will save time for the patients and physicians. Artificial intelligence will also help us in the operating room make decisions that are best for the patient. Every decision that we make in the operating room will be backed up by outcome data, which will help us make the right decision for every patient.

Fred Cushner, MD. Hospital for Special Surgery (New York City): The next game changer for orthopedics is going to be smart implants that are sensor-enabled and provide info and data. The first smart knee was implanted last week, and in time there will be smart hips, smart spine instruments, etc. Big data and AI is going to change orthopedics!

Alok Sharan, MD. NJ Spine and Wellness (Matawan): The next big game changer in orthopedics will be the use of big data and predictive analytics to understand and personalize what treatments patients will need. When a patient walks through the door, based on the particular characteristics of that patient, we should be able to segment and determine what will be the most efficient treatment pathway.

Every payer, whether it is an insurance company or self-insured employer, wants to know the utilization of resources that will be required for an episode of care. If you correctly predict this, then it becomes easier to understand what will be your costs to treat or take care of someone. At this point we have no ability to do that. Actuaries have a very blunt method of predicting and pricing health insurance.

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