Patient driven outcomes in joint replacement surgery - immediate and long term analysis.

Orthopaedic patients are partners in their own assessment process.


Patients assessed by an orthopaedic surgeon as needing hip, knee, ankle or shoulder joint replacement surgery complete scientific assessment forms. These internationally recognized scoring tools record their health and well being, the level of their joint pain and stiffness, and their ability to perform tasks of daily living with their affected joints. By completing the surveys before and after their surgery, the patient's subjective outcome is measured and added to the clinical assessment made by the surgeons.


Several thousand patients have been scored, including DHB patients who have been prioritized for treatment.The orthopaedic surgeons also use the scoring system for the long-term follow up of their joint replacement patients. This allows long-term surveillance of patients over the lifetime of their artificial joint. The system used is unmatched by any other in New Zealand




Greg Murtagh was approached to provide the design and specification for the patient patient driven outcomes solution based on Greg's successful supply of Optical Mark Reading (OMR) technology provided to their Orthopaedic Services group in 2001.

The design and specification phase focused on incorporating internationally proven scientific assessments into a semi-automated solution. Patients would be issued with bar-coded assessment forms depending on their personalized treatment requirements. These forms would then be collated, printed and prepared ready for mail out to the patient. On receipt of the returned form the team using OMR technology would process the forms and the system would score and record the results of the assessment. Electronic integration with local District Health Boards and Surgical Implant suppliers was also part of the design brief to ensure that the end solution focused on results while allowing the team to only deal with exceptions from the entire process.


The delivered solution provided a fully integrated environment linking an SQL compliant database with sophisticated printing and OMR technology. The Open Architecture design of the end solution allowed powerful reporting and analysis tools to be integrated providing an easy to use solution that could be deployed on the business intranet.


Since delivering the solution, substantial enhancements have been made providing new joint types for analysis, integration with surgeons for post surgery complication assessment and incorporation of email based surgeon assessment questionnaires for ankle treatment.


2006 New Zealand Health Innovation Awards

The solution using its innovative patient driven outcomes was nominated for the 2006 New Zealand Health Innovation Awards. Subsequent interrogation of the solution by the 2006 judging panel found that the solution was worthy of a place as a finalist.

The New Zealand Heath Innovation Awards are a joint initiative from the Ministry of Health and ACC where annually the best of the best have a chance to share their innovations with the rest of the medical fraternity.

In June 2006 the solution was presented in-front of the leaders and peers in New Zealand Health.