American Society of Osteoporosis Providers
Edition 9
September 8, 2026
Data is the currency that drives change in healthcare.
Accurate, reproducible data drives policy, prevention, reimbursement, and investment. That same data provides the visibility which drives expansion and support in medicine.
Bone health has worked hard to produce that currency, but the tools available have only been able to generate estimates, approximations built from filters and assumptions that vary depending on who is counting and how. Estimates have carried the field’s arguments for decades, and they have done real work. But the decisions that move a field forward, the ones that set policy, justify reimbursement, and direct research investment, ultimately require something more stable underneath them. They require direct measurement.
That is what ASOP is building. This month, we show the first of what that looks like.
Part 3 of 3: Building the Signal
The first two installments of A Field That Can’t See Itself were about what is lost. The fractures the data cannot distinguish. The surgeon’s observation that has nowhere to go. The clinical truth that is documented and still does not count.
Part 3 is about what ASOP has put forward to fix it.
Two proposals were submitted nationally through the federal coding process. Each one is designed to give a piece of lost information a structured home in the data for the first time.
The Fracture Energy Signal, or FES, would give the energy of a fracturing event a defined place in the fracture code itself. If adopted, a low-energy fracture and a high-energy fracture would no longer be indistinguishable in the data. The fragility fracture, the one that signals underlying bone disease, would become countable as what it actually is, across every age and both sexes, at population scale.
The Bone Structural Integrity Signal, or BSIS, would give the surgeon’s direct observation of compromised bone a structured place to live. When a clinician encounters bone that is weaker than expected, during any procedure from a fracture repair to a dental procedure to an elective joint replacement, BSIS would capture that observation so the most authoritative read on bone quality in all of medicine finally becomes information the field can see and act on.
Neither proposal asks medicine to generate new information. Neither adds a test, a form, or a burden. Each one takes something the field already knows and gives it a place to go.
The information was never missing. What was missing was a place to put it.
Part 3 goes further. It examines who benefits when these signals exist, from the patient whose risk is finally visible to the payers and policymakers whose decisions depend on data the field has never been able to produce. It asks who gets to steer the direction of bone health, and why the answer has been shaped by the asymmetry of who can measure. And it names the most celebrated recent advance in the field, SABRE, and shows how even that milestone inherits the very blindness this series has been about.
The full installment is the most substantial piece ASOP has published. It is written for everyone with a stake in bone health: clinicians, researchers, health system leaders, payers, industry partners, and the patients whose outcomes depend on a field that can finally see itself.
→ Read Part 3 in full at theasop.org/building-the-field
This concludes A Field That Can’t See Itself. The conversation continues this fall with a new thread on the workforce the field has never defined.
From the Field
ASOP’s first clinical implementation site continues to advance. ASOP is providing the training knowledge to support the necessary workforce pipeline. Campbell Clinic is building on that foundation, demonstrating what becomes possible when a bone health program has access to a stable, trained workforce rather than depending on a single clinical champion. We will share more as the data matures. For now, the signal is clear: the model works.
The Founders Forum Is Growing
If what you just read made you want to say something, there is a place for that.
The Founders Forum launched this summer as a series of intimate conversations with the people closest to bone health care. The first sessions are underway, and the voices joining are exactly the ones this was built for: clinicians, program builders, and ecosystem professionals who have been doing this work and have something to say about where it needs to go.
This fall, the Forum expands into a larger quarterly convening, bringing together the broader bone health ecosystem for a structured conversation about the direction of the field. If you have been part of the small groups, you are already in. If you have not yet joined, this is the moment.
The questions remain the same: What do you see that others miss? How does it affect the work you do? What should bone health look like five years from now?
The direction of this field should be set by the people who see it most clearly. That conversation is open.
Building the Currency Requires Investment
ASOP is building the tools that create bone health’s currency for the first time. The measurement framework has been proposed nationally. The competency standard is under development. Clinical implementation is underway.
This work is moving. It requires resources to move at the pace the field needs.
ASOP is a 501(c)(3) nonprofit. For those considering support, gifts of appreciated securities may allow you to avoid capital gains tax while receiving a full fair-market-value deduction. Distributions from donor-advised funds can be directed to ASOP at any time. For individuals over 70½, qualified charitable distributions from an IRA satisfy required minimum distributions while supporting the work tax-free.
Year-end planning season begins now. Your support is how the mint gets built.
All financial and tax-related giving decisions should be reviewed with your financial advisor or tax professional.
The Conversation Continues Between Issues
Each week on LinkedIn, ASOP goes deeper. Systems Monday examines how bone health care actually works and where it breaks down. Literature Thursday looks at what the evidence says and what it does not. Membership Matters explores why this work depends on the people willing to help build it. The full series and the white paper live on the hub.
ASOP is building the workforce pipeline and infrastructure to recognize, support, and manage bone health risk across the lifespan, aligned with science and standards, independent of products and platforms, and focused on the full arc of patient care.
Best Regards,
Dudley Phipps
CEO/Executive Director