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The Impact of COVID-19: A Case Study from Zimmer Biomet

Zimmer Biomet is a leader in musculoskeletal healthcare, with expertise in joint replacement and orthopaedics in general, early intervention, sports medicine and trauma care. In order to maintain our position as a strong and reliable partner, we truly want to add value for our customers and the patients they serve. This is why we go beyond just designing, manufacturing and marketing of high-quality medical devices. For more than 20 years, we have been advocating for a more holistic view to musculoskeletal care, applying evidence-based care pathway management and process optimisation, including patient education, as an integral part of our offering to healthcare providers.

The COVID-19 pandemic has further emphasised that we’ve taken the right approach. Here are some examples of how clinics can benefit from a broader view to care:

  • To limit hospital-stay-related risks, length of stay (LOS) plays an important role. Over the past years we have seen that process optimisation (such as establishing special anesthesia protocols enabling early mobilisation after joint replacement surgery) allows significant LOS reduction[1][2]. The positive effects of this go all the way to ambulatory surgery for a select patient population. This is increasingly important now when efficient use of hospital beds is crucial for care centers. 
  • Ring-fenced beds have been a topic in elective surgery before, with the GIRFT recommendations in 2015 clearly showing the benefits of reduced infections, better outcomes and improved morale[3]. In the current environment, protocols used for containment of infections such as MRSA can be adapted for COVID-19. Utilising COVID-19 green, ring-fenced orthopaedic beds will limit risk to patients of increased infection rates.
  • Making patients “co-producers” of their recovery is a win-win. We have clearly observed that active patient engagement helps improve outcomes and efficiency. Industry can play a key part here, for example by providing technologies that help the patient both pre- and post-surgery by educating about a surgical intervention, guiding through recovery protocols and even enabling remote contact of care workers and patients. Now more than ever, remote solutions are needed to help ensure safety. Such technologies can help not only in being pragmatic when needed, but patient engagement has also proven to improve Patient-Reported Outcome Measures[4][5]
  • When it comes to treating degenerative musculoskeletal diseases, the industry has traditionally focused on the last stage of treatment, i.e. a joint replacement. But clinically valid innovations for early intervention have recently become available that can delay the need for total joint replacement significantly. In the COVID-19 climate, having early interventions to alleviate patients’ pain and improve mobility is beneficial.
  • As many elective surgeries had to be postponed due to COVID-19, hospitals are facing procedure back logs that will need to be addressed once operating rooms (OR) are fully back up and running. Having patients wait for joint replacement longer is related to several disadvantages, including negative socio-economic effects[6][7][8]. To be able to “catch up” in a safe, effective and efficient manner, clinicians need to put focus not just on speed but also on the reproducibility of procedures. Optimised OR protocols including surgery-assisting robots can help here.
  • Even in busy times, sufficient and continued health care professional training is essential. The onset of COVID-19 has had a dramatic impact on surgeon training, both at Consultant and trainee level. Internet-based solutions provide the ability to virtually train, and industry plays an important role there by offering platforms for education and exchange. Training on the safe and effective use of instruments and implants will continue to be a priority, and COVID-19 has shown that it can in many cases be done effectively remotely.

While the pandemic has brought some unprecedented challenges for all of us, I can say that overall, for us as a medical device company it has shown us that our approach to providing care is on the right trajectory. At Zimmer Biomet, it is our mission to improve the quality of life for people around the world, and this can only be achieved if we all join forces. Whether it’s team members, hospital partners, patients or authorities – we all need to contribute, share best practices and learn from one another so we can progress both in the current COVID-19 environment and as we return to our new normal.

Michael Green, Vice President EMEA North Region and General Manager UK & Ireland, Zimmer Biomet

[1] Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg. 2008;248(2):189-198.

[2] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation, BJA. VOLUME 78, ISSUE 5, P606-617, MAY 01, 1997

[3] Green M, Tung E, Al-Dadah O. The value of ring-fenced beds in elective lower limb arthroplasty; Brit J Hosp Med (London, England, 2005) 80(7):405-409, July 2019

[4] Bertakis K, Azari R: Determinants and Outcomes of Patient-Centered Care, Patient Educ Couns 7 August 2010

[5] Bertakis K, Azari R: Patient-Centered Care is Associated with Decreased Health Care Utilization, J Am Board Fam Med May 2011, 24 (3) 229-239

[6] Hibbard JH, Greene J, Overton V. Patients with lower activation associated with higher costs; delivery systems should know their patients' 'scores'. Health Aff (Millwood). 2013;32(2):216-222. doi:10.1377/hlthaff.2012.1064

[7] Greene J, Hibbard JH. Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. J Gen Intern Med. 2012;27(5):520-526. doi:10.1007/s11606-011-1931-2

[8] ​Berwick DM, Nolan TW, Whittington J. The Triple Aim: Care, health, and cost. Health Affairs. 2008 May/June;27(3):759-769.