DXA testing can prevent osteoporosis in at-risk women

Geisinger Health SystemMay 7 2010

Geisinger has exceeded the national benchmark for testing women who are at risk for developing osteoporosis - a silent and serious disease.

According to Eric Newman, M.D., Director, Geisinger Department of Rheumatology, the DXA scan is the industry standard for the diagnosis of osteoporosis and the calculation of fracture risk. National recommendations state that all women over age 65 should receive this test as part of their routine health maintenance. Following the implementation of a three-pronged plan to improve testing rates, Geisinger reports that an unprecedented 74 percent of women over the age of 65 cared for at a Geisinger primary care site have received DXA testing - that is more than 19,000 women. The national rate of women having this diagnostic procedure is only 20 to 30 percent.

"Osteoporosis is a very serious disease. Any woman over age 65 should be tested to determine their future risk of breaking a bone. We were very concerned that a large percentage of women have not been scheduling this simple, painless test that can ultimately save their lives," said Dr. Newman. "This concern prompted a multi-team effort to find ways to close the gap for osteoporosis diagnosis and subsequent care."

Geisinger had been well above the national standard for DXA testing - with a 44 percent DXA testing rate - prior to launching this initiative.

Providers, nurses and technologists from Rheumatology, Endocrinology and community practice sites, in conjunction with Radiology, Laboratory Medicine and Clinical Innovation, developed a series of strategies to reach a larger percentage of at-risk women. Utilizing Geisinger's existing Electronic Health Record (EHR), providers were prompted to schedule DXA testing for patients determined to be at-risk during a routine visit. In addition, EHR records were searched for those women who had not been DXA scanned in the last three years. Letters were sent to this population to schedule an appointment, with follow-up telephone calls if necessary.

"This achievement is a testimony to what we can accomplish with engaged healthcare providers, electronic support systems and organized programs of care delivery. And, this is just the beginning," said Dr. Newman. "In conjunction with our colleagues in Primary Care and Orthopedics, as well as our hospitalists (specialists who provide medical treatment to individuals while they are in the hospital), we have already started exploring ways to ensure that more high-risk patients get on the necessary treatment regimens. In addition, the team is seeking ways to enhance adherence to osteoporosis treatment plans. That is particularly challenging, but given the successes we've already seen, I am confident that those in need of osteoporosis care will get it and we'll prevent many unnecessary and life-threatening fractures."

According to the National Osteoporosis Foundation, osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. Of particular concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain and deformity.