Personalized approach to bone health brings POWER to the patient

Dr. Prism Schneider and her research team at the McCaig Institute for Bone and Joint Health have secured more than $1.2 million in funds from the Partnership for Research and Innovation in the Health System – Digital Health program (PRIHS). This funding, jointly provided by Alberta Innovates and Alberta Health Services, is set to bolster an existing revolutionary digital health-care initiative, empowering patients to take their well-being into their own hands – and devices.  

The initiative, the POWER Program: Personalized Osteoporosis Care with Early Recognition, is an operational provincial digital outpatient service. It features a smartphone app that aids patients in monitoring their bone health and proactively preventing potential fragility fractures. This is done by facilitating early recognition of osteoporosis following a fragility fracture. 

The gap 

A fragility fracture is a broken bone that results from low-energy trauma, like a fall from standing height or less. Every year in Alberta, there are 22,000 new fragility fractures of the wrist, shoulder and spine, excluding hip fractures.

When fragility fractures occur, they are often unexpected, leaving people feeling vulnerable and scared. Unsupported people may feel even more powerless, and this is where the POWER Program provides much-needed assistance. “We have a huge care gap in the way that we provide care for patients with osteoporosis in the outpatient setting, where a patient most commonly presents for the first time with a fragility fracture,” says Schneider, MD'08, PhD'08.

More than 21 per cent of post-menopausal women in Canada have osteoporosis, leading to a projected 24-per-cent increase in fragility fractures by 2030. People experiencing a fragility fracture are two to four times more likely to have another fracture within the next two years, emphasizing the need for early identification and intervention to prevent a continued rise of fragility fractures in Alberta.

Closing the gap 

The POWER program consists of an app compatible with any smartphone, a program-specific website and built-in opportunities for patients to connect virtually with caregivers. “Our POWER program is designed to have multiple access points, so that an emergency room physician, a primary-care physician or a bone-health specialist can refer a patient to the program and patients can even self-refer to gain access to the POWER Program,” says Schneider. 

The POWER Program acts as a central hub of information for the patient, and it is also where they can find their own personalized bone-health care plan. It can provide them with educational material, reminders on how to use their medication and the timing of their next followups.  

The app provides virtual-care opportunities that will help patients avoid expenses and inconveniences such as parking and time off work for in-person appointments. It will especially benefit Albertans living in rural and remote areas by reducing the need for driving to routine followups or reviewing results. 

Schneider has found that participants of all ages are embracing the technology, and she warns that we should not make assumptions about who may or may not be able to adapt to using digital health-care solutions. Schneider adds patients’ desire to be involved in their health care has driven the continued success and advancement of the app. “We're really proud of that and, in just under two years, we've actually enrolled over 270 patients just out of the Foothills Medical Centre Cast Clinic, highlighting the tremendous need for providing better multidisciplinary approaches for fragility fracture care for all Albertans,” says Schneider.

Long-term goals 

The PRIHS funding will help to further enhance and expand the program's impact. From its inception, the app has been co-developed alongside patient-partners, with enhancements being driven by their experiences. "Some of the tools we plan to introduce are inspired by patient feedback," says Schneider. "They have expressed interest in features such as chat group networking, allowing them to discuss injury recovery with fellow patients."  

Schneider emphasizes the importance of patient involvement in health care. “We’re using the app to empower patients within the program to be self-advocates, to be informed and to really participate in their bone health care,” Schneider says.

The long-term goal for the POWER Program and its smartphone app is to provide every patient with a fragility fracture access to the program, thereby improving equitable access to care evenly across the province. 

Giving the POWER to the patient. Right on.