Greater digital patient engagement leads to decreased emergency department visits after total joint arthroplasty

Authors: Jake Corsa¹, Gina Panek, CCRP¹, Rebecca Teng², Brett Wasserlauf, MD¹

¹Saint Francis Hospital and Medical Center, Hartford, CT

²Force Therapeutics, New York, NY

Abstract

Introduction

Medicine has become a challenging environment particularly given the COVID-19 pandemic. The   demand for remote perioperative patient engagement and surveillance is greater now more than   ever to improve healthcare value, patient satisfaction, and patient safety. Emergency department   (ED) encounters add burden to the healthcare system and strategies to eliminate unnecessary   visits need to be prioritized. A digital patient engagement platform is used for all total joint   arthroplasty (TJA) patients at our institution. This study assesses the patient engagement through   an app-based program as it relates to ED visits.  

Methods

Over 15 months, 995 TJA patients were given the opportunity to use the platform. 775 elected to  utilize the application. Patient engagement metrics on the application and patient-reported ED   visit frequency were examined. Patient-reported data collected using the application was   compared to ED visit incidence identified by the institutional database.

Results

On average, patients not requiring an ED visit used the app 10 days longer. The average number of  videos viewed was also greater for this group, particularly postoperatively (60 vs. 32), as was the   number of messages sent from patient to provider (90.3 vs. 53.3). Interestingly, 5.4% of patients   self-reported an ED visit otherwise missed by surveillance alone. Overall, 7.7% of patients not   identified as having a post-acute unscheduled visit were seen at an urgent care facility. Only 3.5%   of patients visiting the ED required an overnight stay.

Discussion

We observed less ED visits when patients were more engaged in the perioperative digital  platform. Opportunities to identify unscheduled visits were also realized. Low admissions from the   ED underscore the opportunity for both improved patient care and decreased healthcare   expenditure by optimizing patient engagement alternatives.