Use of a Recovery Messaging Application in Outpatient Total Joint Replacement

Total joint replacement (TJR) is performed in an outpatient setting for cost containment and reimbursement changes. However, outpatient readmission to the hospital within 30-90 days postoperatively can be costly. Increases in readmission to the hospital less than 30 days postoperatively increase healthcare expenditure and can leave surgical centers without reimbursement. The purpose of the integrative review was to examine 30-day readmission rates for adults post-outpatient TJR within a 12- to 14-week time frame using the recovery messaging application following discharge. A literature search was conducted, and articles were included if they were peer-reviewed academic journals written in English between 2017 and 2022. Fifteen articles were included and evaluated using the John Hopkins evidence summary table to assess the evidence level. The literature analysis identified three themes after using the smartphone application: (a) reducing hospital 30- day readmissions, (b) increasing patient engagement and early mobility, and (c) improving patient outcomes and satisfaction. The findings of this integrative review indicate that using an evidence-based intervention, such as the smartphone application for recovery messaging, can reduce less than 30-day hospital readmissions after outpatient TJR, thus reducing healthcare costs. Future studies should evaluate specific smartphone applications after other general surgical procedures.