The Military Orthopedics Tracking Injuries and Outcomes Network: A Solution for Improving Musculoskeletal Care in the Military Health System

Author:

Mauntel Timothy C12,Tenan Matthew S3,Freedman Brett A4,Potter Benjamin K5,Provencher Matthew T26,Tokish John M7,Lee Ian E8,Rhon Daniel I9,Bailey James R10,Burns Travis C11,Cameron Kenneth L12,Grenier Eric S13,Haley Chad A12,Leclere Lance E14,McDonald Lucas S10,Owens Brett D15162,Pallis Mark P17,Posner Matthew A12,Rivera Jessica C18,Roach Christopher J19,Robins Richard J202,Schmitz Matthew R19,Sheean Andrew J19,Slabaugh Mark A202,Volk William R52,Dickens Jonathan F5212

Affiliation:

1. DoD-VA Extremity Trauma and Amuptation Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20889

2. Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20889

3. Defense Health Agency, Apex, NC 27502

4. Mayo Clinic, Rochester, MN 55905

5. Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD 20889

6. The Steadman Clinic and Philippon Research Institute, Vail, CO 81657

7. Mayo Clinic, Scottsdale, AZ 85259

8. Defense Health Agency, Falls Church, VA 22042

9. US Army Office of the Surgeon General, Falls Church, VA 22042

10. Naval Medical Center San Diego, San Diego, CA 92134

11. Ortho San Antonio, San Antonio, TX 78229

12. Keller Army Community Hospital, New York, 10996

13. Carl R Darnall Army Medical Center, Fort Hood, TX 76544

14. United States Naval Academy, Annapolis, MD 21402

15. University Orthopaedics, East Providence, RI 02914

16. Department of Orthopaedic Surgery, Brown University, Providence, RI 02914

17. Geisinger Musculoskeletal Institute, Wilkes Barre, PA 18702

18. Louisiana State University Health Sciences Center, New Orleans, LA 70112

19. Brooke Army Medical Center, Fort Sam Houston, TX 78324

20. Department of Orthopaedics, United States Air Force Academy, US Air Force Academy, CO 80840

21. Department of Orthopaedics, Keller Army Community Hospital, West Point, NY 10996

Abstract

Abstract Introduction Musculoskeletal injuries are an endemic amongst U.S. Military Service Members and significantly strain the Department of Defense’s Military Health System. The Military Health System aims to provide Service Members, military retirees, and their families the right care at the right time. The Military Orthopedics Tracking Injuries and Outcomes Network (MOTION) captures the data that can optimize musculoskeletal care within the Military Health System. This report provides MOTION structural framework and highlights how it can be used to optimize musculoskeletal care. Materials and Methods MOTION established an internet-based data capture system, the MOTION Musculoskeletal Data Portal. All adult Military Health System patients who undergo orthopedic surgery are eligible for entry into the database. All data are collected as routine standard of care, with patients and orthopedic surgeons inputting validated global and condition-specific patient reported outcomes and operative case data, respectively. Patients have the option to consent to allow their standard of care data to be utilized within an institutional review board approved observational research study. MOTION data can be merged with other existing data systems (e.g., electronic medical record) to develop a comprehensive dataset of relevant information. In pursuit of enhancing musculoskeletal injury patient outcomes MOTION aims to: (1) identify factors which predict favorable outcomes; (2) develop models which inform the surgeon and military commanders if patients are behind, on, or ahead of schedule for their targeted return-to-duty/activity; and (3) develop predictive models to better inform patients and surgeons of the likelihood of a positive outcome for various treatment options to enhance patient counseling and expectation management. Results This is a protocol article describing the intent and methodology for MOTION; thus, to date, there are no results to report. Conclusions MOTION was established to capture the data that are necessary to improve military medical readiness and optimize medical resource utilization through the systematic evaluation of short- and long-term musculoskeletal injury patient outcomes. The systematic enhancement of musculoskeletal injury care through data analyses aligns with the National Defense Authorization Act (2017) and Defense Health Agency’s Quadruple Aim, which emphasizes optimizing healthcare delivery and Service Member medical readiness. This transformative approach to musculoskeletal care can be applied across disciplines within the Military Health System.

Funder

Congressionally Directed Medical Research Program

Defense Health Program Work Unit

Uniformed Services University of the Health Sciences

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

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