Geisinger Health System of Danville, Pa., has launched three new orthopedic programs in its ProvenCare line of best-practice derived treatment protocols: hip fracture, total hip, and total knee.

“Since introducing the new ProvenCare orthopedic protocols, we’ve already witnessed a 50 percent decrease in readmissions and a 10 percent reduction in length of stay figures when it comes to total hip replacements,” said Michael Suk, M.D., chairman of Geisinger Health System’s Department of Orthopedic Surgery, who has led his team’s effort at integrating ProvenCare into orthopedics. “By employing evidenced-based protocols for all hip and knee surgeries, we are able to ensure the same high quality care is delivered to every patient, every time.”

Geisinger began implementing the ProvenCare methodology in 2006 by testing and rewarding how elective cardiac surgery was performed and by offering a “warranty” on coronary artery bypass surgeries. By eliminating unwarranted variation and applying scientific best practices to coronary artery bypass graft patients, Geisinger has been able to reduce readmissions, complications and length of stay while raising its profit margin by 17 percent.

ProvenCare is a multifaceted program that, for inpatient procedures, includes the reengineering of care using evidence-based "bundles" of discrete clinical elements and a "patient compact" that provides education and encouragement to patients to become more engaged in their own care. When insurers are willing, it also involves adoption of a fixed per-case rate that covers preadmission, inpatient and follow-up care.

The ProvenCare hip and knee arthroplasty programs, for example, both have a 45-point checklist that patients go through from admission, surgery, discharge, and follow up. The ProvenCare program has also expanded to cover other procedures and conditions, including bariatric surgery, perinatal care, diabetes and coronary artery disease.

Geisinger is bringing its ProvenCare modules to the market through xG Health, an independent Geisinger startup launched in 2013.


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