Fracture Prevention Through Automation

Using an automated system to identify patients being treated for fractures who are at high risk for osteoporosis and generating letters to the patients to encourage follow-up can effectively promote osteoporosis intervention and prevent fractures, according to researchers at Penn State College of Medicine.

A Penn State news release says the researchers used a spreadsheet created with monthly data from Penn State Milton S. Hershey Medical Center’s finance department to analyze treatment codes. The analysis enabled investigators to identify 103 patients aged 50 and older with fractures that appeared to be related to fragility. The researchers then sent letters to the patients within three months of their emergency room visits warning them they may be at risk for osteoporosis; the letters encouraged the patients to visit their doctors or the hospital’s bone health clinic for an examination. Three months after the letter, investigators phoned the patients to determine whether follow-up treatment had occurred.

For comparison, the researchers also conducted six-month follow-up phone calls to 98 patients who did not receive letters. During these calls, investigators asked the patients whether they were being treated for osteoporosis or had plans for a follow-up examination after their fractures.

The investigators found that 60 percent of patients who received a letter had followed up with their care compared with 14 percent of patients who did not receive a letter.

“Progressive bone fragility leads to greater risk for fractures,” Edward Fox, M.D., professor of orthopedics at Penn State College of Medicine, said in the news release. “Hospitals treat fragility fractures, but they have no system in place to evaluate those same patients for osteoporosis to prevent the next fracture. This study’s results are better than no letter or doing nothing, which is what most hospitals are doing, including the one piloting our program before it started this program.”