OAKLAND, CA – HealthConnect, Kaiser Permanente's electronic health record system, is at the core of a new osteoporosis prevention program that officials say could drop the nation's hip fracture rate by 25 percent.

The Kaiser initiative will use HealthConnect – dubbed the world's largest civilian electronic health record database – to collect data on patients that included anti-osteoporosis medication use, bone density scans and fragility fractures.

Aggressively managing patients at risk for osteoporosis could reduce the hip fracture rate in the United States by 25 percent, according to a Kaiser Permanente study published in the November issue of the Journal of Bone & Joint Surgery. The first step must be a more active role by orthopedic surgeons in osteoporosis disease management, researchers say.

The study, the largest to look at osteoporosis management in men and women over 50 years old, followed 650,000 men and women in Kaiser Permanente's osteoporosis management program and found hip fractures dropped by 38 percent, preventing 970 hip fractures in 2007.

It examined the effectiveness of the Kaiser Permanente Southern California's Healthy Bones Program from 2002 to 2007.

A recent report showed that Kaiser Permanente in Southern California leads the nation in effective osteoporosis disease management. The National Committee on Quality Assurance, a private, non-profit organization dedicated to improving healthcare quality, recently released the results in its Quality Compass study of reporting health plans for 2008. Of the 10 million Americans who have osteoporosis, 80 percent are women.

"Currently in the United States, the rate of treatment after a fragility fracture is only 20 percent. Treatment after a fragility fracture at Kaiser Permanente in Southern California is now 68 percent," said the study's lead author, Richard M. Dell, MD, an orthopedic surgeon at Kaiser Permanente in Downey, Calif. "Healthcare would be drastically improved if this model of osteoporosis care were adapted for the rest of America."

The Healthy Bones Program aggressively targets people at risk for hip fractures by identifying them through KP HealthConnect to ensure they get the bone density screenings and medications they need. The multidisciplinary team includes orthopedic surgeons and providers from endocrinology, family practice, internal medicine, rheumatology, gynecology, physical therapy, disease/care management, radiology and nursing education.

In the study, researchers found that annual bone density screening rates increased by 263 percent from 2002 to 2007, from 21,557 scans in 2002 to 78,262 scans in 2007. During the span, the number of people on anti-osteoporosis medications increased by 153 percent, from 33,208 to 84,155.

"The most important thing an orthopedic surgeon should know about osteoporosis/fracture prevention is that we can take action that helps to prevent hip and other fragility fractures," Dell said. "Simple steps like suggesting calcium and vitamin D for all your patients and bone mineral density testing in patients at higher risk for osteoporosis should be considered part of your daily practice."

More than 300,000 hip fractures are reported annually in the United States. Twenty-four percent of people who experience a hip fracture end up in a nursing home, 50 percent never reach their functional capacity and 25 percent of patients over 65 years of age with a hip fracture die in the first year after the incident.