Study: Fitness devices useful in orthopedic surgery--could offer means to placate CMS

The Centers for Medicare & Medicaid Services is implementing an ambitious requirement for patient engagement that takes effect starting next year. Hospitals are required to have more than 10% of patients engage with their electronic health record in some way, with a specific emphasis on patient-generated health data that must be incorporated into the records of more than 5% patients.

Dr. Claudette Lajam, assistant professor of orthopedic surgery at NYU Langone Medical Center

If healthcare facilities fail to meet these requirements, they stand to be subject to financial penalties from CMS. Researchers have taken these requirements seriously; a recent study examines the top 27 most popularly reviewed consumer fitness devices to assess their features and the ability of these to offer useful information before and after orthopedic surgery.

"Fitness devices have the potential to transform orthopaedic care," said lead study author Dr. Claudette Lajam, an assistant professor of orthopedic surgery at NYU Langone Medical Center, said in a statement. "If we can get people more involved in their care and help them get in better shape, then everyone wins--patients, physicians, and the entire health care system."

The study is by New York University researchers with data presented on March 4 at the American Academy of Orthopaedic Surgeons (AAOS) meeting.

The researchers evaluated each device for its potential usefulness in orthopedic applications such as tracking compliance with physiotherapy, including distance walked and stairs completed as well as compliance with activity restrictions. They could be useful in the preoperative prep for the detection of sleep apnea, blood glucose monitoring, weight and activity level. After surgery, they can also track patient outcomes including walking and stairs completed.

They found that of the reviewed devices, most synced with an online or smart device app. More than one-third had a battery life of more than 7 days. About one-quarter were waterproof, with almost three-quarters qualifying as water resistant.

In terms of the tracking features, 85% included a pedometer with 63% including a heart rate monitor. Sleep was recorded on 63% of these devices, mostly as length and quality of sleep. Twenty of the devices enabled weight tracking, while 22 offered calorie intake tracking. Only one could test for sleep apnea, while three could monitor glucose readings.

Only 15% of them link directly to EMRs, but more than two-thirds had some capability for data sharing.

"Fitness device technology has yet to be explored or implemented widely in orthopedic surgery," the researchers concluded. "We demonstrated how fitness devices can assist the orthopedic surgeon in measurement of basic outcomes and can also assist with preoperative, perioperative and postoperative care."

- here is the announcement
- and here is the study
- finally, here is the CMS final rule on EMR implementation