DJO® Announces Industry-First Risk Assessment Tool To Confirm Outpatient Joint Replacement Pathways

DALLAS–(BUSINESS WIRE)–DJO, a leading provider of medical technologies designed to get and keep people moving, announced today the availability of the industry’s first Outpatient Arthroplasty Risk Assessment tool, the OaraScore^™. The easy-to-use software tool provides medical professionals with the information needed to assess the appropriate post-operative length of stay after total joint arthroplasty (TJA).

The ability to identify patients for outpatient joint replacement surgery with a validated and consistent tool is essential to any rapid discharge program. With the removal of total knee arthroplasty (TKA) procedures from the Centers for Medicare & Medicaid Services (CMS) inpatient-only list, hospitals need effective tools to determine the appropriate patient length of stay and to minimize re-admission rates, two major drivers of cost in the TJA episode of care.

Among the more well-known factors leading to the shift of TJAs to the outpatient ambulatory setting are:

• Improvements in implant technology and medical techniques;
• Growing evidence that joint replacement surgeries can be performed safely and cost-effectively without an inpatient hospitalization; ¹
• Increasing consumer demand for care in lower-cost settings as well as a preference for at-home recovery. ²

The commercial introduction of the OaraScore was announced at the 2018 Annual Meeting of American Association of Hip and Knee Surgeons (AAHKS, Booth # 510).

The OaraScore is part of DJO’s industry-leading healthcare solutions platform, MotionMD^®. The subscription-based, Software-as-a-Service (SaaS) tool was developed for DJO leading proprietary implant technologies such as the EMPOWR Knee^™ and Hip Systems but can also be used for other implant systems. The OaraScore was developed in partnership with R. Michael Meneghini, MD, Director of Orthopaedics and Joint Replacement and Peter Caccavallo, MD, Medical Director of Peri-Operative Medicine, both from Indiana University Health Saxony Hospital.

The OaraScore utilizes a validated, multi-disciplinary algorithm that was featured in a peer-reviewed study published in The Journal of Arthroplasty in August 2017 by Dr. Michael Meneghini. The retrospective study, “Safe Selection of Outpatient Joint Arthroplasty Patients with Medical Risk Stratification: The “Outpatient Arthroplasty Risk Assessment Score” revealed a patient’s OaraScore for total joint replacement more precisely predicted the ability for the patient to discharge home the same day or the next morning than existing risk tools, such as ASA and CCI.³

“Surgeons generally have a good sense of which patients will do well in an outpatient or rapid discharge environment,” said Dr. Peter Caccavallo. “OaraScore allows the medical professionals to move beyond that standard and utilize a scientifically sound and consistent approach to risk stratification.”

The utility and favorability of the tool has also been independently validated in an AAHKS podium presentation by Duke University researchers in 2016 and in an independent study by New York University Langone Medical Center (link) published in The Journal of Arthroplasty in August 2018.^4,5

While several factors lead to OaraScore’s improved effectiveness, a key differentiator is that OaraScore^™ is the first patient selection tool developed specifically for total joint replacement patients.

“Previous risk stratification tools looked at more superficial measures like patient motivation, home support and pre-operative physical and mental condition,” said Jeffery A. McCaulley, Global President of DJO Surgical^®. “OaraScore is the only clinically validated, peer reviewed risk stratification tool for total joint arthroplasty, and its values are derived by evaluating nine critical co-morbidity factors and overall medical conditions, all in real time.”

In addition to utilizing OaraScore to determine if patients are low risk or high risk for outpatient joint replacement surgery, the software also tracks readmission rates and compares data to all other physicians utilizing the tool. All confidential patient data remains encrypted throughout the process.

“OaraScore provides medical professionals with a more consistent and verifiable methodology to reliably and safely base admission decisions,” said McCaulley. “Considering the flexibility, portability and ease of use of this tool, we believe OaraScore could become the standard of clinical practice.”

MotionMD^® is an intuitive, web-based, point-of-care software solution designed to support claims management and inventory dispensing. This automated paperless solution can fully integrate with electronic medical records (EMR), electronic ordering, billing and practice management systems. The solution is designed to help orthopedic clinics improve patient satisfaction, better manage billing compliance and streamline workflow by providing seamless interoperability with clinic records. In October 2018, Motion MD has processed more than 1.5 million patient agreements since it launched in 2016.

On Thursday, November 1, 2018, at DJO Surgical’s Industry symposium in conjunction with the AAHKS 2018 Annual Meeting, Dr. Meneghini will present a more expansive data set from his previous August 2017 study while discussing outpatient total joint arthroplasty and patient selection.

For more information about OaraScore, please visit: djoglobal.com/oarascore

^1. Barad, Steven J., Stephen M. Howell, and Joyce Tom. “Is a shortened length of stay and increased rate of discharge to home associated with a low readmission rate and cost-effectiveness after primary total knee arthroplasty?.” Arthroplasty today 4, no. 1 (2018): 107-112.

^2. Rovinsky, Michael; Looby, Sean, and Zacchigna, Laura. “The shift to outpatient TKA – what’s the big deal?.” HFM Magazine July 2018.

^3. Meneghini, R. Michael, Mary Ziemba-Davis, Marshall K. Ishmael, Alexander L. Kuzma, and Peter Caccavallo. “Safe selection of outpatient joint arthroplasty patients with medical risk stratification: the “outpatient arthroplasty risk assessment score”.” The Journal of arthroplasty 32, no. 8 (2017): 2325-2331.

^4. Henderson, Robert, et al. “External Clinical Validation of the OARA Score for Outpatient Joint Arthroplasty Candidates”. Podium Presentation at AAHKS Meeting 2016, Paper #26.

^5. Kim, Kelvin Y., James E. Feng, Afshin A. Anoushiravani, Edward Dranoff, Roy I. Davidovitch, and Ran Schwarzkopf. “Rapid Discharge in Total Hip Arthroplasty: Utility of the Outpatient Arthroplasty Risk Assessment Tool in Predicting Same-Day and Next-Day Discharge.” The Journal of arthroplasty (2018).

Dr. R. Michael Meneghini is a consultant for DJO Global.

Dr. Peter Caccavallo is a consultant for DJO Global.

About DJO^®

DJO^® is a leading global developer, manufacturer and distributor of high-quality medical devices that provide solutions for musculoskeletal health, vascular health and pain management. The Company’s products address the continuum of patient care from injury prevention to rehabilitation after surgery, injury or from degenerative disease, enabling people to regain or maintain their natural motion. Its products are used by orthopedic specialists, spine surgeons, primary care physicians, pain management specialists, physical therapists, podiatrists, chiropractors, athletic trainers and other healthcare professionals.

In addition, many of the Company’s medical devices and related accessories are used by athletes and patients for injury prevention and at-home physical therapy treatment. The Company’s product lines include rigid and soft orthopedic bracing, hot and cold therapy, bone growth stimulators, vascular therapy systems and compression garments, therapeutic shoes and inserts, electrical stimulators used for pain management and physical therapy products. The Company’s surgical division offers a comprehensive suite of reconstructive joint products for the hip, knee and shoulder. DJO Global’s products are marketed under a portfolio of brands including Aircast^®, Chattanooga^®, CMF™, Compex^®, DonJoy^®, ProCare^®, DJO Surgical^®, Dr. Comfort^® and Exos^®. For additional information on the Company, please visit www.DJOGlobal.com.