October 2001 Bulletin

OKO cyberspace library goes online Oct. 15

AAOS puts 21st century knowledge-tool in hands of members—all day , every day

By Carolyn Rogers

Orthopaedic Knowledge Online (OKO), the Academy’s dynamic cyberspace library, will be launched October 15, providing members with a 21st century tool to care for their patients. Several years in the making, Orthopaedic Knowledge Online (OKO) is a 24/7 web site that gives members instant access to orthopaedic information and current surgical techniques, providing video demonstrations and text-based information regarding the diagnosis, treatment and management of musculoskeletal disorders. The site will be constantly evolving, with new topics added and updates provided on an ongoing basis.

Orthopaedic Knowledge Online (OKO) can be accessed at www.aaos.org/ oko or in a building on the Orthopaedic Campus which is in the Medical Education section of the AAOS home page at www.aaos.org.

"It’s great to see it come to fruition," says Richard H. Gelberman, MD, Academy president and the site’s long-time champion. "It’s better than I envisioned."

Dr. Gelberman’s involvement with what is now known as OKO dates back to 1995, when he was chair of the Academy’s Council on Education. "The concept of ‘just-in-time’ education was first discussed at a 1995 Council on Education retreat," Dr. Gelberman recalls. "The idea behind ‘just-in-time’ was to provide critical data to surgeons whenever and wherever they needed it—in the office, at home, in the emergency room—using state-of-the- art technology at their fingertips. That was the early concept.

"The Council committed to the goal that the Academy should serve as the knowledge core for graduates of orthopaedic surgery programs. We wanted to build a core of orthopaedic knowledge that would be provided to our members in the most efficient, effective way possible."

At that time, William A. Grana, MD, OKO’s co-editor-in-chief says, "technology was such that the Board of Directors and the Council didn’t feel they could do an online program and present the techniques and sophisticated imaging clearly enough that surgeons could get value from it."

Later, at a December 1999 Board of Directors meeting, the idea was reintroduced to develop a site where orthopaedists could refresh themselves on a procedure, find out what the indications and contraindications are for the procedure, as well as the best way to diagnose, treat and follow-up. Dr. Gelberman, then second vice president and leader of a forward-thinking initiative known as "The AAOS in 2005", was a major impetus in getting the "just-in-time" site initiated.

The Council on Education discussed the idea more fully and created a work group made up of Evan L. Flatow, MD, and Leesa M. Galatz, MD—both shoulder surgeons, explains Marilyn Fox, director of the Academy’s publications department.

"Dr. Joseph Zuckerman, chair of the Council on Education, charged them with creating a prototype for the site," Fox says. "They worked with staff and an outside production company to create the prototype. Once it was developed, it was reviewed internally and by orthopaedic surgeons who offered their comments. Then it was refined."

Mark Wieting, vice president for education programs, and Howard Mevis, director of the electronic media, evaluation and course operations department, created a business plan for the site. "We received approval from the Board of Directors in June 2000, along with funding to move ahead with the creation of this site," Mevis says.

Shortly thereafter, in a brainstorming session with AAOS staff to name the site, "Orthopaedic Knowledge Online" emerged as the winner. "We thought it should be named something that would fit within the whole realm of Academy education materials," Dr. Grana says. "And this seemed to fit in with Orthopaedic Knowledge Update, which is the publication version of this material."

In their roles as co-editors-in-chief,. Dr. Grana and Robert H. Fitzgerald Jr., MD, oversee the work of 10 section editors across all subspecialties in orthopaedics. They’ve also been working closely with Jane Baque, OKO managing editor, for the last year getting the site ready for use, Fox adds. "Jane, along with Kate Scotese, has been instrumental in the development of OKO and has really done a fantastic job."

OKO’s information is presented in layers, Baque explains. "The first layer of information—images, text, video—can be viewed in about 10 minutes. For more in-depth information, you can read selected additional resources and information. The third layer brings to bear all of the Academy’s educational resources—abstracts from JAAOS [Journal of the American Academy of Orthopaedic Surgeons], articles and chapters from other publications—full text for the doctor to read."

This layered design enables users to spend a few minutes retrieving a piece of information, or hours reviewing new information in the field, as well as classic concepts, Baque points out.

Focus groups made up of "user peers" have reviewed the site, Baque says. "These focus groups were made up of Academy members, primarily general orthopaedic surgeons with special interests. In most cases, they were at the Academy for courses, and were brought in to review the site."

Reaction was overwhelmingly positive. One adaptation that was made in response to focus group comments was to increase the number of minutes of video that are available. "That’s a really important element," Baque says. "We’re using a lot more video than we originally planned. And we’re trying to keep the content short and to the point."

"Areas of controversy" for each topic will be addressed as well, Dr. Grana adds. "This will be done in an audio format, where you’ll actually hear the authors discussing their opinions on that specific topic area," Dr. Grana says. "We’ll also be including a ‘what’s in the future?’ section. For example, we’ve asked Dr. William Rodkey to report what’s on the horizon in terms of meniscal treatment and replacement."

Eight topics will be complete when the site goes "live" on October 15. They are meniscal tears, ACL tears, hallus valgus reconstruction, rotator cuff tears, supracondylar fractures, ankle sprains, femoral shaft fractures and hyaluronic acid. Topics that should follow shortly thereafter include TKA alignment, scaphoid fractures and proximal humeral fractures.

Each topic represents one of the following subspecialties: sports medicine, foot and ankle, pediatrics, shoulder and elbow, trauma, hand and wrist, hip and knee reconstruction, nonoperative orthopaedics and spine.

"We’ll have 12 topics posted by the end of the year," Dr. Grana reports. "And we’ll be meeting again soon to develop the schedule for 2002. We hope to have another 12 to 15 topics posted by the end of 2002.

"One of the neat things about this site is that materials can be updated and changed frequently—on a monthly or yearly basis. Another benefit is if you leave your book in your office, you’ll be able to access the same information online at home."

In May 2001, Dr. Zuckerman presented the OKO business plan and the finalized prototype to the Board of Directors. The Board approved the plan and also agreed that OKO should be a member benefit.

The marketing department is preparing to launch an aggressive marketing and direct mail campaign encouraging Academy members to check out the site. The campaign’s purpose is to create awareness of OKO and the practical, useful nature of the service; specifically, the 24/7 convenience of the site and the fact that it’s a continuously expanding complement of resources to orthopaedic surgeons’ personal libraries.

The five-month introductory campaign carries the catchphrase "The start of something big." The idea is to let members know that the site cannot start out as a huge database—it will be relatively small compared to what it ultimately will become. Once 2002 rolls around, the marketing efforts will shift into the main campaign, which will focus on the convenience of OKO and how it serves as a complement to an orthopaedist’s personal library. OKO also will be prominently featured at the Academy’s Annual Meeting in Dallas, Texas in February.

"Over time, our goal is to provide an educational resource that provides tremendous depth and breadth for Academy members—and is available whenever they need it," Mevis says. "When they go to OKO, they’ll know they’re going to get reliable, high quality information that’s going the meet their needs, and they won’t have to waste their time searching for information on sites that may not be complete, accurate and up-to-date."

"It’s really a matter of evolution," Dr. Fitzgerald says about the future of OKO. "Eventually it will evolve into a virtual orthopaedic warehouse. The key issue at this stage, though, is to make it available to the members, get their feedback and modify it. It really needs the members of the Academy."

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