Orthopaedic referrals using a smartphone app: Uptake, response times and outcome

Morkel, R. W.; Mann, Theresa N.; Preez, G du; Toit, Jaco du

doi:10.7196/samj.2019.v109i11.13986

Cited by 16 publications

(15 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this context, research has focused on the orthopedic clinician's use of digital technologies [1,17], for instance, in supporting their educational development [18], guiding clinical decision support [19], managing care referrals [20], and building the patient-clinician relationship [21,22]. Recognizing and understanding the potential unmet needs of elective orthopedic surgery patients is central to motivating healthier behavior change, improving their recovery, and optimizing overall surgical success in the short and long term [23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Robinson¹,

Slight²,

Husband³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

Background Health behavior changes made by patients during the perioperative period can impact the outcomes and success of elective surgeries. However, there remains a limited understanding of how best to support patients during this time, particularly through the use of digital health interventions. Recognizing and understanding the potential unmet needs of elective orthopedic surgery patients is central to motivating healthier behavior change, improving recovery, and optimizing overall surgical success in the short and long term. Objective The aim of this study is to explore patient perspectives on technology features that would help support them to change their lifestyle behaviors during the pre- and postoperative periods, and that could potentially maintain long-term healthy lifestyles following recovery. Methods Semistructured interviews with pre- and postoperative elective orthopedic patients were conducted between May and June 2020 using telephone and video call–based software. Patient perspectives on the use of digital technologies to complement current surgical care and support with lifestyle behavior changes were discussed. Interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data, with QSR NVivo software (version 12) facilitating data management. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 18 participants were interviewed. Four themes were developed from the data regarding the design and functionality of digital technologies to best support the perioperative journey. These center around an intervention’s ability to incorporate interactive, user-centered features; direct a descriptive and structured recovery; enable customizable, patient-controlled settings; and deliver both general and specific surgical advice in a timely manner. Interventions that are initiated preoperatively and continued postoperatively were perceived as beneficial. Interventions designed with personalized milestones were found to better guide patients through a structured recovery. Individualized tailoring of preparatory and recovery information was desired by patients with previously high levels of physical activity before surgery. The use of personalized progression-based exercises further encouraged physical recovery; game-like rewards and incentives were regarded as motivational for making and sustaining health behavior change. In-built video calling and messaging features offered connectivity with peers and clinicians for supported care delivery. Conclusions Specific intervention design and functionality features can provide better, structured support for elective orthopedic patients across the entire surgical journey and beyond. This study provides much-needed evidence relating to the optimal design and timing of digital interventions for elective orthopedic surgical patients. Findings from this study suggest a desire for personalized perioperative care, in turn, supporting patients to make health behavior changes to optimize surgical success. These findings should be used to influence future co-design projects to enable the design and implementation of patient-focused, tailored, and targeted digital health technologies within modern health care settings.

show abstract

Section: Introductionmentioning

confidence: 99%

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Robinson¹,

Slight²,

Husband³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…While it may be expedient to meet healthcare users on the platforms they already use, such as the use of SMS or WhatsApp in MomConnect, 15 when designing a system for a smaller group of collaborating professionals it may be possible to move the entire group to a different, fit-for-purpose IP, such as the Vula app for patient referrals in South Africa. 16,17 There are also risks in designing an intervention that is platform specific. During the ASOS-2 trial, the choice of IP platform was often country specific (unpublished data).…”

Section: Editorialmentioning

confidence: 99%

WhatsApp and Internet Protocol messaging in healthcare : a transformative opportunity

Duys

Park-Ross

Straaten

et al. 2021

Southern African Journal of Anaesthesia and Analgesia

View full text Add to dashboard Cite

“… 16 A recent study conducted by the Orthopaedic Department of Tygerberg hospital suggests that the Vula App is a successful alternative to traditional referral methods. 17 Furthermore, the finding that one-third of referrals were managed by giving advice over the app suggests that the Vula App can decrease the workload of overburdened referral hospitals. 17 …”

Section: Introductionmentioning

confidence: 99%

“… 17 Furthermore, the finding that one-third of referrals were managed by giving advice over the app suggests that the Vula App can decrease the workload of overburdened referral hospitals. 17 …”

Section: Introductionmentioning

confidence: 99%

Use of the Vula App to refer patients in the West Coast District: A descriptive exploratory qualitative study

2022

View full text Add to dashboard Cite

Background: Referral systems play a pivotal role in coordination and quality of care and should be evaluated for their utility. The Vula App is used by various disciplines and hospitals in South Africa to refer patients. The aim was to explore the perceptions of medical practitioners regarding the use of the Vula App in the West Coast District.Methods: A descriptive, exploratory qualitative study used semi-structured interviews with 11 medical practitioners. The highest and lowest users of the Vula App were selected from seven district hospitals. Qualitative data analysis used the framework method and Atlas-ti.Results: There were five themes: impact on the referral process, quality of care, coordination of care, continuous professional development, and how to improve the Vula App. Its use was well established in the outpatient and semi-urgent setting, but participants were hesitant to rely on it for immediate advice. Specialist advice via the Vula App enabled practitioners to manage patients remotely. The referral hand-over function had a positive impact on the coordination of care. Advice and feedback via the Vula App assisted with continuous professional development.Conclusion: The Vula App is a useful tool to refer patients to the emergency centre and outpatient departments. It can improve the immediate quality of care and sequential coordination of care. It has the potential to enable continuous professional development. There is a need to standardise its use, to ensure electronic information flows back to the district and to integrate the data into the district’s health information system.

show abstract

Orthopaedic referrals using a smartphone app: Uptake, response times and outcome

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 16 publications

References 14 publications

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

Designing the Optimal Digital Health Intervention for Patients’ Use Before and After Elective Orthopedic Surgery: Qualitative Study

WhatsApp and Internet Protocol messaging in healthcare : a transformative opportunity

Use of the Vula App to refer patients in the West Coast District: A descriptive exploratory qualitative study

Contact Info

Product

Resources

About