Cost-Effective Mobile-Based Healthcare System for Managing Total Joint Arthroplasty Follow-Up

Abstract

ObjectivesLong-term follow-up care after total joint arthroplasty is essential to evaluate hip and knee arthroplasty outcomes, to provide information to physicians and improve arthroplasty performance, and to improve patients' health condition. In this paper, we aim to improve the communication between arthroplasty patients and physicians and to reduce the cost of follow-up controls based on mobile application technologies and cloud computing.MethodsWe propose a mobile-based healthcare system that provides cost-effective follow-up controls for primary arthroplasty patients through questions about symptoms in the replaced joint, questionnaires (WOMAC and SF-36v2) and the radiological examination of knee or hip joint. We also perform a cost analysis for a set of 423 patients that were treated in the University Clinic for Orthopedics in Essen-Werden.ResultsThe estimation of healthcare costs shows significant cost savings (a reduction of 63.67% for readmission rate 5%) in both the University Clinic for Orthopedics in Essen-Werden and the state of North Rhine-Westphalia when the mobile-based healthcare system is applied.ConclusionsWe propose a mHealth system to reduce the cost of follow-up assessments of arthroplasty patients through evaluation of diagnosis, self-monitoring, and regular review of their health status.

Identifying complications requiring re-operation following primary hip or knee arthroplasty: a consecutive series of 98 patients

“…Providing remote care requires organisational resources to survey patients; however, we expect a net benefit in favour of reduced organisation costs, consistent with predictions by others [ 24 ]. Employing allied staff to provide remote care might be controversial for some surgeons, [ 19 ] but preliminary evidence suggests that allied staff, such as physiotherapists can safely and effectively complete post-arthroplasty reviews [ 28 , 29 ].…”

“…Elsewhere, studies indicate that remote post-arthroplasty review compared to in-person review produces lower financial costs to patients, shorter review times, less travel time, less burden on carers, fewer unscheduled outpatient visits and high levels of patient satisfaction; all without missing complications [ 21 – 23 ]. Modelling indicates substantial cost savings and increased quality-adjusted life years from remote models of care [ 24 , 25 ].…”

Modern Internet Search Analytics and Total Joint Arthroplasty: What Are Patients Asking and Reading Online?

“…Especially for practices that are shifting towards outpatient arthroplasty, eliminating the postoperative hospital stay reduces the opportunity for patients to ask questions and receive counseling [ 32 ]. Smartphone applications and telemedicine have been used to improve patient monitoring and communication with some success [ 33 , 34 ]. In one study, patients who engaged with their surgical team via telemedicine postoperatively were found to have higher satisfaction compared to traditional follow-up [ 35 ].…”

Healthcare professionals’ proposed eHealth needs in elective primary fast‐track hip and knee arthroplasty journey: A qualitative interview study

“…For instance, in orthopaedics, mobile techniques have been used to assess knee flexion (Dietz, Sprando, Hanselman, Regier, & Frye, 2017;Mehta et al, 2017;Pereira, Rwakabayiza, Lécureux, & Jolles, 2017) and cup positioning (Kurosaka et al, 2016;Meermans & Kats, 2013). In addition, automated mobile-delivered interventions have been used to increase perioperative communication (Day et al, 2018), manage follow-up (Bitsaki, Koutras, Heep, & Koutras, 2017;Clari et al, 2015) and reduce the occurrence of postoperative adverse events (Krumsvik & Babic, 2017). Correspondingly, Internetdelivered behavioural interventions have been used in telerehabilitation, especially in rural areas (Russell, Buttrum, Wootton, & Jull, 2011;Tousignant et al, 2015).…”