A Patient-Focused Technology-Enabled Program Improves Outcomes in Primary Total Hip and Knee Replacement Surgery.

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Digital Health

Background:

• A technology-enabled patient engagement and pathway management program was evaluated for patients undergoing primary total hip and knee replacement.
• The program integrated health services and multimedia features with enhanced recovery after surgery (ERAS) protocols.

Purpose of the Study:

• To assess the impact of the program on length of stay (LOS) after hip and knee replacement.
• To evaluate the program's effect on clinical, patient-focused, and financial outcomes.

Main Methods:

• A cohort of 2,080 patients was divided into pre-program (retrospective) and program (prospective) groups.
• The program cohort was further analyzed based on eligibility for outreach support (OS) versus non-outreach support (NOS).
• Clinical outcomes were assessed for all patients; patient-focused outcomes were assessed for a subset.

Main Results:

• Significant reductions in LOS were observed: 20-42% for hip replacement and 9-31% for knee replacement (p < 0.001).
• No significant negative impact on clinical outcomes (readmissions, complications, ED re-attendance).
• Improved patient-reported outcomes, higher overall health gain, and enhanced patient experience (p < 0.001 to p = 0.003).
• Older patients and those with higher comorbidity benefited most.

Conclusions:

• Technology-enabled programs can enhance care and reduce costs for lower-limb arthroplasty patients.
• Shorter inpatient stays, improved patient outcomes, and enhanced experience deliver substantial value, particularly for complex patients.