AAOS Now, July 2020
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Practices Can Benefit from Remote Patient Monitoring
We are all adjusting to the new social distancing recommendations and economic strains that have accompanied this crisis, which presents an opportunity for orthopaedists to embrace technology and improve healthcare outcomes.
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Financial Fears and the COVID-19 Response
Although the first major wave of COVID-19 may have peaked in most of the United States, we are still coming to grips with the impact of the pandemic on orthopaedic surgery and, particularly, its finances.
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A Resident’s Perspective on Education During the COVID-19 Pandemic
COVID-19 has turned the world upside down. As the virus spread across the United States, every person had to take a step back and reevaluate within the context of a new normal. With elective surgery canceled to preserve personal protective equipment and maximize intensive care unit (ICU) capacity, many orthopaedic surgery residents were redeployed to assist in emergency rooms and ICUs. With new roles in the hospital, and social distancing preventing large group learning, we have had to reexamine our plans for continued resident education. We had to take inventory of our resources and take advantage of the technology at our disposal.
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Podcast Recap: CMS Regulatory Response to COVID-19
A recent add-on episode for AAOS’ new advocacy podcast, “The Bone Beat,” offered orthopaedic surgeons the unique opportunity to hear directly from the Centers for Medicare & Medicaid Services (CMS) on the agency’s response to COVID-19. Senior Medical Advisor in the Office of the Administrator Marion Everett Couch, MD, PhD, MBA, shared insights on the difficult decision to recommend postponing nonemergent surgeries and procedures during the pandemic, as well as the sweeping regulatory changes made to help America’s healthcare systems prepare.
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Orthopaedic Surgeon Transitions to Frontline COVID-19 Physician
Being one of the busiest hospitals in the largest and second most populous borough in New York City, New York–Presbyterian/Queens Hospital cared for hundreds of patients infected with COVID-19. Alexander Golant, MD, FAAOS, associate director of sports medicine at the New York–Presbyterian/Queens Department of Orthopaedic Surgery in Flushing, N.Y., and assistant professor of clinical orthopaedic surgery at Weill Cornell Medicine, transitioned from orthopaedic surgeon to frontline provider.
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Personal Protective Equipment: Orthopaedic Surgeons Face Ongoing Supply Chain Crisis
Many individuals demonstrated not only altruism but also innovation to help manage a shortage of personal protective equipment (PPE) during the height of the COVID-19 crisis, a few of whom are highlighted below. PPE can include cloth masks, made of woven fabric, often of natural fibers such as cotton; medical/surgical masks with nonwoven fabric, often of manufactured fibers such as polypropylene; and respirators such as N95s and, in Europe, FFP2, which are made of even more tightly meshed polypropylene, which can exclude viral particles.
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How Did We Only Have 1 Percent of the Masks Needed to Fight COVID-19?
Spring came early in New York City this year, but you wouldn’t have known that by reading the news. Instead, you read of mounting cases of the dreaded SARS-CoV-2 and its associated illness, COVID-19.
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An Overview of Medical PPE Masks for Orthopaedic Surgery
Orthopaedic surgery mask requirements may be more specialized due to the physical nature of many of the specialty’s procedures. This article provides a general overview of different medical mask options. As there are regional and case-specific requirements, no assertions are made about best practices.
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Orthopaedic Leader Becomes PPE Supply Chain Expert and Unifier During the COVID-19 Crisis
Lisa Lattanza, MD, FAAOS, became chair of the Department of Orthopaedics & Rehabilitation at Yale School of Medicine and chief of orthopaedics at Yale New Haven Hospital on Sept. 1, 2019. She began her tenure by creating a strategic plan and hosting a retreat to get to know her organization and create a shared vision. All was going swimmingly until the outset of a global pandemic.
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Academy Registry Program Now Captures COVID-19 Data
The Academy’s Registry Program is now collecting COVID-19 data through the capture of the International Classification of Diseases, 10th revision (ICD-10) code for COVID-19 confirmed diagnosis, U07.1. The new code is enabled across each of the AAOS registries, comprising the American Joint Replacement Registry (AJRR), Shoulder & Elbow Registry, Musculoskeletal Tumor Registry, and American Spine Registry, the latter a collaborative effort between the American Association of Neurological Surgeons and AAOS.
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Congressional Response to COVID-19
The congressional response to the COVID-19 pandemic has encompassed four major pieces of legislation and trillions of dollars in new spending since early March. As the healthcare industry adapts to this unprecedented crisis, AAOS continues to work with allies in Congress to ensure that its priorities, including the preservation of orthopaedic private practice, are advanced in relief legislation.
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The Impact of COVID-19 on Orthopaedic Residency Training
The COVID-19 pandemic brought about near-universal cessation of elective surgeries and noncritical clinic visits around the nation. In addition, government mandated stay-at-home orders decreased the number of people sustaining injuries in everyday activities, reducing the volume of new patients requiring acute orthopaedic interventions. Many orthopaedic surgery programs have changed residents’ rotations to balance safety, training, and continued delivery of urgent and emergent orthopaedic care. Although stay-at-home orders and restrictions on elective surgeries have been lifted in some areas, many changes may last long beyond the pandemic.
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The Future of Telemedicine Is Evolving
A recent two-part series published in AAOS Now discussed the history of telemedicine (TM) and its current application (“Telemedicine in Orthopaedics: Risks Versus Benefits,” December 2019; “Liability and Billing Concerns,” January 2020). Since then, the world has been embroiled in the COVID-19 pandemic, and acceleration of the use of TM has been one byproduct. Undoubtedly, the perception, understanding, and utility of TM have evolved rapidly for patients and healthcare providers. This article presents orthopaedic aspects of federal legislative changes pertaining to TM, particularly billing and regulatory changes, as well as an overview of TM best practices.