Authors: Justin T Butler DO, Ryan DeCook BS, Joyce Harary, Thomas Bradbury MD, Brandon Naylor DO
Abstract
Introduction
As Internet-based patient engagement platforms (IPEPs) become increasingly utilized following THA, a clearer understanding of their role in influencing clinical outcomes is needed. This study aims to determine whether increased patient engagement with an IPEP has notable impacts on patient-reported outcome measures (PROMs) and post-acute care visits.
Methods
This retrospective study analyzed 5,557 patients who underwent Total Hip Arthroplasty (THA) and participated in an Internet-based Patient Engagement Platform (IPEP) from 2018 to 2022. Patients were categorized based on their engagement levels with the IPEP, measured as high or low based on the frequency of interactions. Key outcomes assessed included procedural satisfaction, pain scores, functional and mental health measures (VR-12 MCS/PCS, HOOS JR.), and post-operative healthcare utilization, including emergency room visits and readmissions. Statistical Analysis: All data was analyzed with unpaired t-tests.
Results & Discussion
The high engagement group included 2820 patients, average age of 67.8 years old, 57% being female, and an average BMI of 28.7 kg/m2. The low engagement group included 2737 patients, average age of 66.6 years old, 54% female, and an average BMI of 28.8 kg/m2. Higher patient engagement demonstrated improved patient outcomes in all five categories: procedural satisfaction, pain scores, HOOS, JR., VR-12 Mental, and VR12 Physical. Higher patient engagement using IPEP demonstrated significantly better outcomes in PROMs and functional assessments compared to the ‘lower engagement’ cohort. Increased educational resources, perioperative guidance, and empowering patients through active participation may translate to improved clinical outcomes. Further analysis is needed to determine optimal utilization and associated content of IPEPs.
Conclusion
IPEPs demonstrate promising improvement in patient outcome scores, procedural satisfaction, and pain scores for patients undergoing THA. Higher engagement may also decrease ED visit and readmission rates. Further, increased educational resources, perioperative guidance, and empowering patients through active participation in these platforms may improve clinical outcomes. Future studies evaluating costeffectiveness, optimal utilization, associated content, AI integration, and application across other orthopedic pathologies remain desirable research questions.
