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Published on: August 1, 2019
Surgeon-patient Communication Using the Electronic Portal: Effect on Postoperative Outcomes and Patient-reported
Background:
Electronic medical record portals enable real-time communication between patients and surgeons after total knee arthroplasty (TKA). This study evaluated the impact of message timing and frequency on postoperative outcomes and patient-reported outcome measures (PROMs).
Materials And Methods:
We retrospectively reviewed 9,353 primary TKAs performed at a single academic institution. Of these, 1,219 patients sent messages within 2 weeks of surgery (early), 507 sent messages between 2 and 8 weeks (late), and 7,627 did not message.
Results:
Patients who messaged within 2 weeks following surgery had shorter hospital length of stay (LOS) (41.2 vs 47.45 vs 53.40 hours, P < .001) and were more likely to be discharged home (99.5% vs 97.6% vs 96.8%, P < .001) compared to both late messengers and non-messengers. Patients who messaged late were more likely to experience a 90-day readmission surgery (3.2% vs 5.3% vs 3.3%, P = .05). Most messages were sent within 2 weeks (1.76 vs 1.48; P < .001). There was no difference in PROMs regardless of message timing, and there was no association between the number of messages sent and perioperative outcomes or PROMs.
Conclusion:
Older age and longer LOS were associated with less patient-initiated contact after TKA. Older patients may be less familiar with digital platforms and less likely to send messages. Early messaging may reflect heightened recognition of postoperative issues, enabling counseling or intervention and reducing readmissions. These findings underscore the importance of preoperative education and equitable access, though long-term effects of messaging warrant further study.
