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Barbara Houle speaks about her experience getting knee surgery at Southern Vermont Medical Center.
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Dr. Michael B. Sparks from Dartmouth-Hitchcock Orthopaedics, center, makes a point while DHMC colleague Dr. Nicholas Paddock, director of orthopedics, left, and Dr. Jonathan Cluett from SVMC Orthopedics look on.

SVMC Grant Enables Data Collection to Boost Patient-Centered Care

By Rebecca DravisiBerkshires Staff
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Officials from Dartmouth-Hitchcock Medical Center, Southern Vermont Health Care and the Aircast Foundation gather in the SVMC Orthopedics office in Bennington, Vt., on Thursday. Right, the plaque marks the new collaboration.

BENNINGTON, Vt. — In 1950, Barbara Houle injured her leg in a skiing accident. She couldn't straighten or bend her knee, and the surgical solution at the time involved removing all the cartilage. That, however, had its own side effects.

"As I got older … it was bone on bone. The noise was worse than the pain," Houle said. "The pain I had I could cope with."

But this past summer, Houle's husband went to the Southern Vermont Medical Center Orthopedics for his second hip replacement and met Dr. Jonathan Cluett. Houle decided she, too, would consult with Cluett about her noisy knee, and she ended up having surgery in August. Now, she's doing much better, she said.

"It has been successful. I don't need my cane 

anymore," she said.

While SVMC Orthopedics gave her a new knee, Houle gave SVMC Orthopedics something precious, as well: her data. Houle was one of the first patients to fill out surveys throughout her surgical experience that will be entered into a new database SVMC is keeping in conjunction with Dartmouth-Hitchcock Medical Center with the help of a $100,000 grant from the Aircast Foundation. 

On Thursday afternoon, Houle joined Cluett, doctors from Dartmouth-Hitchcock and officials from Aircast to discuss the grant, which is enabling SVMC Orthopedics to adopt Dartmouth-Hitchcock's GreenCare Model, a data-gathering research program DHMC has been using since 2011. The goal of the GreenCare Model is to increase both health care quality and patient satisfaction while decreasing costs.

The GreenCare model uses data collected from patients like Houle — who said she was "glad to pass along the information" about her experience — to predict outcomes for similar patients in the future. SVMC is the first facility outside of the DHMC to use its program.

Dr. Michael B. Sparks from Dartmouth-Hitchcock Orthopaedics said the traditional patient-doctor model would involve a meeting where the doctor would basically tell the patient what the best path was.

"We feel at Dartmouth that's probably not the best way," he said. 

Instead, under the GreenCare Model, the patient fills out a survey that asks questions about his or her physical and mental health, lifestyle and more in an effort to take a more holistic and data-driven approach to future decisions made in a partnership between the doctor and patient. It has worked well at Dartmouth-Hitchcock, Sparks said, but the more data the better, which is why pairing up with SVMC will help them. 

"We need to make sure it's done across the population," he said. "It's great if we can do it places like Dartmouth-Hitchcock. But in this country most health care is delivered in places like this."

Indeed, the partnership will help SVMC by offering them access to a model that most smaller community hospitals don't have access to. Southern Vermont Health Care CEO Thomas A. Dee said it's part of his hospital pushing itself to "raise the bar" on patient care.

"We're looking to create a single standard of care," Dee said, while looking to serve the community in its hometown, avoiding long drives to larger hospitals. "It allows care to be closer to home. We're excited about it."

The GreenCare Model started with orthopedics because there are more than 1 million knee and hip replacements done annually across the United States, and that number is growing. And more than half of those surgeries are being done at small community hospitals, said Nicholas Paddock, director of orthopedics at DHMC.

"It's never been more important to get this right," he said.

The focus at SVMC will be on surgeries related to arthritis to start with, with a goal of expanding to all orthopedic surgeries at some point. The model could also eventually be used in other specialties, like cardiology or cancer care, Dee said.

The collaboration, dubbed the Dartmouth-Hitchcock (D-H) Orthopedic Research and Education Endowment at Southwestern Vermont Health Care, is being administered with a three-year plan. The plan includes collecting the data — which started July 1 in Bennington — and then creating software to bring all the data together between DHMC and SVMC, which are clinically affiliated with each other but do not share a patient records system. Ultimately, the research is expected to lead to written reports to inform national healthcare policy for other orthopedic procedures and beyond.

SVMC also needs to raise a matching $100,000 by December, said Leslie Keefe, vice president of Corporate Development for the SVHC Foundation. But for now, SVMC is happy to have the $100,000 grant from the Aircast Foundation, the philanthropic arm of Aircast, a leader in orthopedic braces, which took interest in the project for its proximity to its own mission of advancing the science of prevention, healing  and rehabilitation in orthopedics. 

Aircast President Jack McVicker attended the news conference on Thursday to talk about why his foundation chose this project — and it all started with a ski injury, just like it did for Houle. McVicker said his stepfather, Glenn Johnson, the founder of Aircast, developed his own cast when he suffered a skiing injury at nearby Stratton Mountain and was unhappy with his heavy traditional plaster cast. He invented a cast that involved placing air bags inside to give better mobility, and that invention sparked the creation of Aircast. But even though he knew it worked, he really didn't know why it worked, and that search for the "why" led to the creation of a foundation to offer assistance to educational institutions like Dartmouth-Hitchcock to study the why — and give back to the orthopedic community.

"We've been chasing this DaVinci Code our whole life," McVicker said, saying his stepfather always liked to talk about how "serendipitous" his life had been and that this celebration dovetailed with that. "How serendipitous. You think we're helping you. You're helping us learn the why."

Tags: dartmouth-hitchcock,   health care,   SVMC,   

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