Skip to main content
SpringerLink
Log in

Peer-to-Peer Collaboration Adds Value for Surgical Colleagues

  • General Interest
  • Published:
HSS Journal ®

Abstract

Background

Peer-to-peer advisory among colleagues in orthopedic surgery is commonplace in academic medical centers. In the private practice setting, however, it becomes more difficult for surgeons to discuss complex cases among peers.

Purpose/Questions

We sought to study the effect of peer-to-peer mentorship on surgeons’ decision-making and on patient care across academic and private adult joint reconstruction practices via the use of group secured messages.

Methods

From 2013 to 2016, we established a messaging system that was compliant with the Health Insurance Portability and Accountability Act (HIPAA) among five previous adult hip and knee reconstruction co-fellows in order to discuss complex cases. Data collected from each case included patient demographics (age and sex), history and physical examination, relevant imaging in orthogonal planes, and preliminary diagnosis and treatment plans. Data collected from group responses included nature of additional inquiries, literature citations, operative recommendations, and sample imaging of similar cases previously treated.

Results

The group consisted of two private practice surgeons and three academic surgeons. Data was collected on 283 cases discussed during the study period. None of the patients had any HIPAA violations. The mean number of reviewers who commented on a case was 2.4, with at least one response in 97% of cases. In 33% of the cases, the peers confirmed the initial treatment plan, and in 67% of the cases, an alternative treatment plan was recommended and executed. The case distribution was 94 primary and 189 revision procedures, including 173 hips, 103 knees, three ankles, two shoulders, and two pelvises.

Conclusion

In the majority of cases exchanged between young surgeons via a group messaging system, a significant impact on patient care was appreciated. In a technology-driven era, peer-to-peer advisory for difficult cases via a rapid feedback method may allow for substantial improvement in patient care, particularly for surgeons not practicing at a large academic medical center with access to several partners and multiple opinions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Aviram M, Ophir R, Raviv D, Shiloah M. Experiential learning of clinical skills by beginning nursing students: “coaching” project by fourth-year student interns. J Nurs Educ. 1998;37:228–231.

    CAS  PubMed  Google Scholar 

  2. Benger JR, Noble SM, Coast J, Kendall JM. The safety and effectiveness of minor injuries telemedicine. Emerg Med J. 2004;21(4):438–445.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Bozic KJ, Ward L, Vail TP, Maze M. Bundled payments in total joint arthroplasty: targeting opportunities for quality improvement and cost reduction. Clin Orthop Relat Res. 2014;472:188–193.

    Article  PubMed  Google Scholar 

  4. Brennan JA, Kealy JA, Gerardi LH, Shih R, Allegra J, Sannipoli L, Lutz D. Telemedicine in the emergency department: a randomized controlled trial. J Telemed Telecare. 1999;5(1):18–22.

    Article  CAS  PubMed  Google Scholar 

  5. Chong WW, Aslani P, Chen TF. Shared decision-making and interprofessional collaboration in mental healthcare: a qualitative study exploring perceptions of barriers and facilitators. J Interprof Care. 2013;27(5):373–379.

    Article  PubMed  Google Scholar 

  6. Daruwalla ZJ, Wong KL, Thambiah J. The application of telemedicine in orthopedic surgery in Singapore: a pilot study on a secure, mobile telehealth application and messaging platform. JMIR Mhealth Uhealth. 2014;2(2):e28.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Erickson GP. Peer evaluation as a teaching-learning strategy in baccalaureate education for community health nursing. J Nurs Educ. 1987;26:204–206.

    CAS  PubMed  Google Scholar 

  8. Escovitz ES. Using senior students as clinical skills teaching assistants. Acad Med. 1990;65:733–734.

    Article  CAS  PubMed  Google Scholar 

  9. Froimson MI, Rana A, White RE, Jr, Marshall A, Schutzer SF, Healy WL, Naas P, Daubert G, Iorio R, Parsley B. Bundled payments for care improvement initiative: the next evolution of payment formulations: AAHKS Bundled Payment Task Force. J Arthroplasty. 2013;28:157–165.

    Article  PubMed  Google Scholar 

  10. Henning JM, Weidner TG. Peer assisted learning in the athletic training clinical setting. J Athl Train. 2006;41:102–108.

    PubMed  PubMed Central  Google Scholar 

  11. Joseph B, Pandit V, Khreiss M, et al. Improving communication in level 1 trauma centers: replacing pagers with smartphones. Telemed J E Health. 2013;19(3):150–154.

    Article  PubMed  Google Scholar 

  12. Keehan SP, Cuckler GA, Sisko AM, et al. National health expenditure projections, 2014-24: spending growth faster than recent trends. Health Aff (Millwood). 2015;34(8):1407–1417.

    Article  PubMed  Google Scholar 

  13. Kurtz SM, Ong KL, Lau E, Bozic KJ. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021. J Bone Joint Surg Am. 2014;96(8):624–630.

    Article  PubMed  Google Scholar 

  14. Olson SA, Obremskey WT, Bozic KJ. Healthcare technology: physician collaboration in reducing the surgical cost. Clin Orthop Relat Res. 2013;471(6):1854–1864.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Pape B, Thiessen PS, Jakobsen F, Hansen TB. Interprofessional collaboration may pay off: introducing a collaborative approach in an orthopedic ward. J Interprof Care. 2013;27(6):496–500.

    Article  PubMed  Google Scholar 

  16. Przybylo JA, Wang A, Loftus P, Evans KH, Chu I, Shieh L. Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow. J Hosp Med. 2014;9(9):573–578.

    Article  PubMed  Google Scholar 

  17. Tachakra S, Lynch M, Newson R, Stinson A, Sivakumar A, Hayes J, Bak J. A comparison of telemedicine with face-to-face consultations for trauma management. J Telemed Telecare. 2000;6(Suppl 1):S178–S181.

  18. Vaidya SR. Improving teaching and learning through peer coaching. Education. 1994;115:241–245.

    Google Scholar 

  19. Wu RC, Morra D, Quan S, et al. The use of smartphones for clinical communication on internal medicine wards. J Hosp Med. 2010;5(9):553–559.

    Article  PubMed  Google Scholar 

  20. Wu R, Lo V, Morra D, et al. A smartphone-enabled communication system to improve hospital communication: usage and perceptions of medical trainees and nurses on general internal medicine wards. J Hosp Med. 2015;10(2):83–89.

    Article  PubMed  Google Scholar 

  21. Wu R, Rossos P, Quan S, et al. An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. J Med Internet Res. 2011;13(3):e59.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hospital for Special Surgery, New York, NY, 10021, USA

    Ameer M. Elbuluk MD

  2. Mercer-Bucks Orthopaedics, Lawrenceville, NJ, 08648, USA

    Michael P. Ast MD

  3. Norton Orthopedic Associates, Louisville, KY, 40214, USA

    Jeffrey D. Stimac MD

  4. Henry Ford Medical Center, Dearborn, MI, 48216, USA

    Trevor R. Banka MD

  5. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA

    Matthew P. Abdel MD

  6. Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, 10003, USA

    Jonathan M. Vigdorchik MD

Authors
  1. Ameer M. Elbuluk MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael P. Ast MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeffrey D. Stimac MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Trevor R. Banka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Matthew P. Abdel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jonathan M. Vigdorchik MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan M. Vigdorchik MD.

Ethics declarations

Conflict of Interest

Ameer M. Elbuluk, MD, Michael P. Ast, MD, Jeffrey D. Stimac, MD, Trevor R. Banka, MD, Matthew P. Abdel, MD, and Jonathan M. Vigdorchik, MD, declare that they have no conflicts of interest.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013.

Informed Consent

Informed consent was waived from all patients for being included in this study.

Required Author Forms

Disclosure forms provided by the authors are available with the online version of this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elbuluk, A.M., Ast, M.P., Stimac, J.D. et al. Peer-to-Peer Collaboration Adds Value for Surgical Colleagues. HSS Jrnl 14, 294–298 (2018). https://doi.org/10.1007/s11420-018-9616-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11420-018-9616-6

Keywords

Search

Navigation