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Upper-Extremity Outcomes: We are all in this Together

Jupiter, Jesse MD

Techniques in Hand & Upper Extremity Surgery: June 2016 - Volume 20 - Issue 2 - p 53
doi: 10.1097/BTH.0000000000000121

Techniques In Hand & Upper Extremity Surgery, Weston, MA

Conflicts of Interest and Source of Funding: The author reports no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Jesse Jupiter, MD, Techniques In Hand & Upper Extremity Surgery, Weston 02493, MA. E-mail:

We continue to strive to produce improvements in the quality of health care, including clinical practice guidelines, performance measures and systematic reviews, and patient safety programs.

Today we are faced with the challenge of meeting Federal mandates from center for medicare and medicaid services to develop quality outcome data to include patient-reported outcomes and standardized performance measures as we face the specter of payment based upon our documentation of patient care.

Recently the stakeholders involved in upper-extremity care, including the American Society for Surgery of the Hand, American Association for Hand Surgery, American Shoulder and Elbow Surgeons, Arthroscopy Association of North America, and American Society of Sports Medicine, met in Orlando to discuss our mutual approaches to meet these challenges.

Not only will it be necessary to define and agree upon the optimal patient-reported outcomes, such as disability of arm, shoulder, hand and region-related scores, the specific criteria to base performance on, but also the means to collect these data, such as use of the Patient Reported Outcome Measure Instrument System or EQ5d or VR!2.

All sounds confusing to say the least and will require a concensus reached by close cooperation with all surgical groups and our national organizations such as the American Academy of Orthopaedic Surgery and the American Society for Plastic and Reconstructive Surgery

“Concensus means that lots of people believe collectively what nobody believes individually”

Abba Eban

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