More than 50 members represent the AAOS as liaisons on committees, expert panels, and work groups sponsored by federal agencies and other organizations. Liaisons serve as musculoskeletal experts to review quality measures, develop standards and appropriateness criteria, provide input on medical device reviews, and continuously examine published materials on advances in research, medical care, and treatment.
The number of AAOS liaisons has grown significantly over the last few years as these interactions have proven to greatly benefit the Academy. In addition, more organizations have made an effort to include orthopaedic surgeons on their work groups. Today, the Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), Food and Drug Administration (FDA), Joint Commission, National Athletic Trainers Association, and National Quality Forum are just a few of the groups that seek out orthopaedic liaisons.
"The importance of the liaisons is undeniable. They are our eyes and ears on the ground," said William Shaffer, MD, AAOS medical director, who oversees the liaison program. "They are able to provide orthopaedic input on various issues and can report back to the Academy to better align our goals with other organizations."
What do liaisons do?
Liaisons serve in many capacities, depending on the mission and activities of the core group. The AAOS has a liaison member on the Surgical Quality Alliance. This group of surgical specialtists and anesthesiologists helps define the principles of quality measurement and increase awareness about safety and quality in all surgical settings. Among the tasks undertaken by this group are the following:
- collate measures of surgical care quality
- share development methodologies across specialties to create tools for quality improvement
- evaluate the use of registries
- serve as a point for disseminating information among surgical specialty societies and anesthesiology groups on quality-related initiatives underway in the federal and private sectors
- coordinate surgery's response to those initiatives
The AAOS has also nominated members to the board of directors of the Commission on Motion Lab Accreditation. This commission enhances the clinical care of persons with disorders of human movement by evaluating and accrediting clinical motion laboratories. The National Association of Emergency Medical Technicians invited the AAOS to nominate members to advise on preparing the Second Edition of Advanced Medical Life Support. This curriculum addresses how to best assess and manage the most common medical crises in patients.
AAOS members also serve on key federal work groups such as the Medicare Evidence Development and Coverage Advisory Committee, which provides advice and guidance to the Secretary of the Department of Health and Human Services and the CMS administrator concerning the adequacy of scientific evidence available to CMS for "reasonable and necessary" determinations under Medicare.
The AHRQ's Evidence Based-Practice Center updated an evidence review conducted in 2007 on the effectiveness of treatments for osteoarthritis of the knee. An AAOS liaison member was nominated and selected to serve on a technical expert panel, providing advice on issues that should be considered and on the technical aspects of the literature.
Orthopaedic surgeons also serve on the FDA Science Board. This board provides advice on specific complex scientific and technical issues important to the FDA and its mission, including emerging issues within the scientific community.
Liaison members have served on an expert panel focused on providing input on CMS' Physician Compare website. Additionally, the Academy has nominated liaisons to the Global Alliance for Musculoskeletal Health's Models of Care panel, which is working with the World Health Organization on a range of strategic initiatives to raise the awareness of the global impact of musculoskeletal conditions.
In 2014, CMS contracted with the Yale New Haven Health Services Corporation Center for Outcomes Research and Evaluation (CORE) to develop measures that use patient-reported outcomes to assess the quality of outpatient care. CORE developed a measure of hospital visits following outpatient surgery conducted in ambulatory surgery centers and potentially in hospital outpatient departments. An orthopaedic surgeon was selected to serve on this expert panel.
These and the many other liaisons are able to emphasize the importance of musculoskeletal care in their roles. New positions are created continuously and the Academy strives to involve more members based on expertise. The AAOS also promotes resident and fellow involvement in these liaisons positions.
"Our goal is to appoint the most talented and committed members for AAOS activities as well as involving as many new members as possible," said Gerald R. Williams Jr, MD, first vice-president and chair of the Committee Appointment Program (CAP) Committee.
Each liaison position is linked to a relevant AAOS committee and council with similar charges and objectives. The committee chair is given the liaison contact information and a description of the project. Liaisons are asked to provide reports on their work group or expert panel. This defined process has helped create a collaborative effort on many fronts, including developing performance measures, preparing grant applications, and responding to procurement requests.
Some liaisons are appointed directly by the AAOS, but in other situations, the AAOS nominates a member for consideration and the requesting organization makes the final selection.
The appointment process for liaison positions is similar to the appointment process for committee positions. Service as a liaison does not prevent a member from serving on other AAOS committees. Positions are posted on the Committee Appointment Program website (www.aaos.org/cap) as they become available.
Occasionally, requesting organizations have short timelines for nominations, so AAOS members who are interested in serving should check the CAP web page regularly. Liaisons may serve from one month to several years, based on the organizations' needs. The variation in term lengths and the broad range of topic areas appeal to many physicians with specific expertise and limited time to volunteer.
The AAOS is grateful to our current liaisons for volunteering their time to represent the AAOS and orthopaedic surgeons in many critical work groups and projects. A complete list of liaisons and their assignments can be found here.
Kyle Shah is the clinical quality & medical affairs coordinator in the AAOS office of government relations. She can be reached at firstname.lastname@example.org