​Dr. Anthony DiGioia, '75, Releases New Book

Dr. Anthony DiGioia, '75, Orthopaedic Surgeon and Medical Director at the Bone and Joint Center and Innovation Center at Magee-Womens Hospital of UPMC, recently released released a new book, The Patient Centered Value System: Transforming Healthcare through Co-Design. We caught up with Dr. DiGioia to learn more about his new book and his career path. Tell us about your education and career path from Central until now.

I was born and raised in the East End of Pittsburgh and grew up in Penn Hills. After graduating from Central Catholic High School (Class of ’75), I graduated from Carnegie Mellon University with a degree in Civil Engineering and a graduate degree in Civil and Biomedical Engineering. Beginning in 1982, I attended Harvard Medical School (Class of ‘86), then completed an orthopaedic surgery residency at UPMC and an Adult Reconstruction Fellowship at Massachusetts General Hospital.

One of my goals has always been to bridge the gap between engineering and medicine and to develop unique teams that solve real world problems. I initially worked to become a leader in the development of the field of medical robotics and computer assisted surgery. In the 1990’s, I performed the first ever robot navigated total hip replacement here in Pittsburgh. A goal has always been focused on bringing diverse multi-disciplinary teams together to co-design care to meet the needs of patients and families. This broad focus then led to the development the Patient Centered Value System (PCVS), which combines process and performance improvement with technologies to improve clinical outcomes and patient and family care experiences, while reducing costs. This is a simple, replicable approach that will transform care delivery by viewing all care through the eyes of patients and families and building implementation teams to improve the way we deliver care today.

How did a Central Catholic education help prepare you for your future?

Central Catholic, from academics to sports and extracurricular activities, gave me a solid foundation for my engineering and medical careers as well as set the stage for life-long learning. Innovations are built on the shoulders of giants and I am proud to stand tall with Central Catholic and its alumni community. I was very honored several years ago to be admitted into the Central Catholic Hall of Fame.

Why did you decide to pursue a career in orthopaedics?

I played football for the Vikings during all 4 years of high school. During my junior year, I suffered a season ending ankle injury that required surgery. This was my first introduction to an orthopaedic surgeon and orthopaedics in general. I continued to play football at CMU and became interested in the field of biomechanics. I was fortunate to train and work with Dr. Albert Ferguson, an orthopaedic surgeon who championed the importance of working with other disciplines, and particularly engineers, to solve real world clinical problems. It was there that the intersection of my medical and engineering interests flourished and led to the development of career as an orthopaedist who is still an engineer!

Tell us about your experience as a pioneer in medical robotics and computer assisted surgery.

After an internship in general surgery and a residency in orthopaedic surgery at UPMC, I returned to Boston for a one-year fellowship in Adult Reconstructive Surgery at Massachusetts General Hospital, with a focus on hip and knee replacements. After completing my training in 1992, I returned to Pittsburgh to start a practice and, at the same time, started a research lab which pulled together an interdisciplinary team of engineers and computer experts from Carnegie Mellon to advance the science of robotics in medicine.

Initially our team focused on joint replacement computer simulations as a way to plan for surgery. Eventually we combined robotics with computer- assisted surgical tools and figured out how to use robotics as a navigation tool, creating what was described as “a GPS system for surgeons.” It proved to be a breakthrough. Robotics and computer-assisted tools allowed for a more precise alignment of an implant. We learned that to be able to reproduce the technique with such precision meant consistently better outcomes for all patients.

Eventually, I realized that my focus on surgical robotics and computer technology was silo-ing my own vision of truly improving patient care and having a greater impact on a much larger patient population. It became clear that there was a need to focus on the entire patient experience. Along with that clarity came the belief that it was also essential to include the patient’s family in every step of the process because as a caregiver, I could see that family members played an enormous role in a patient’s life—before, during, and after treatment.

I refocused myself on understanding, building upon and ultimately improving the entire patient experience. Using process and system improvement sciences, shadowing and a strong implementation team, coupled with performance metrics, my practice and our program at Magee has been able to implement the Patient Centered Value System with incredible success, which is now being adopted nationally and internationally. The book The Patient Centered Value System: Transforming Healthcare through Co-Design is available on Amazon and CRC Press.

Tell us about your book, The Patient Centered Value System: Transforming Healthcare through Co-Design. 

The Patient Centered Value System has the potential to be the new “operating system” for health care that will help hospitals, healthcare systems, clinicians and insurance companies to co-design and achieve value-driven clinical outcomes while improving patient experience and reducing cost. This simple, replicable approach is a system for viewing all care through the eyes of patients and families, building implementation teams to improve processes and for determining the true cost to deliver care in any setting.

The way to center care around patients, families and front-line providers is to involve them in the co-design of the care delivery system. By shadowing, or following a patient through their healthcare journey, all stakeholders in the process, from the patient to a doctor or x-ray technician, have a voice in creating the best patient experience possible. Using a newly developed app and online tool called goShadow (goShadow.org), shadowing is now completely digitized and easier to implement in any organization than ever before.

In healthcare, we must put the patient and family at the center of all we do. It is vital to the success of any system to gain feedback from all partners in care to truly design the most optimal experience.

You can see the Patient Centered Value System in action at www.discoverdrd.com.

Learn more about goShadow by visiting www.goshadow.org.

What are your hopes for the future of orthopaedics?

My hope for the future of all healthcare, not just orthopaedics, is that the combination of technology and process improvement will continue to transform the way we care for our patients and improve system of care delivery. It is critical that these elements support one another, as new technologies, while innovating and exceptional, do not lead to lasting change alone. New technologies, techniques, even implants, must be coupled with a consistent focus on system and experience improvement, with the patient as the center of it all.

What is your advice for the Class of 2018?

Hard work, forward thinking and collaboration are the cornerstone of all innovation and having an impact. There are three essential keys to future success. First, always have a vision. Having a goal to work towards is necessary in order to frame your journey to success. Secondly, have a passion for your goal. Finding joy in your work is crucial. Lastly, build your team to help implement your plan and reach your goal. With these three keys, you will be on the path to success in the future and beyond.

Also, be sure to nurture your relationships with your educators, classmates and friends. Their input may be crucial to your successes in the future.

Any final thoughts?

The ultimate goal of the work that my team and I do is to truly transform care delivery for every patient, everywhere. Using the three keys to success, a vision, passion and a committed team, I believe we have the ability to begin a revolution in healthcare. With the Patient Centered Value System, it is now possible for any care team to improve patient experience and healthcare delivery in any setting. With the tools and the PVCS roadmap, sustainable, meaningful change is possible for every organization.