Modern instant messaging platform for postoperative follow-up of patients after total joint arthroplasty may reduce re-admission rate

Abstract

Background: Follow-up after artificial joint replacement greatly helps achieve surgical outcomes. Mobile internet technology and mobile terminal equipment may increase the effectiveness of artificial joint replacement. However, only a few studies have evaluated the effectiveness of this technology. We aimed to analyze the reasons and outcomes of patients who used the instant messaging platform after undergoing artificial joint replacement. Methods: Among the 548 cases of arthroplasty (250 hips, 298 knees) performed between December 2015 and June 2018 in the Department of Joint Surgery of our institution; 358 (164 hip joints, 194 knee joints) participated in instant messaging platform consultation, whereas the remaining 190 (86 hip joints, 104 knee joints) participated in traditional telephone consultation, as a control group. Follow-up time was from December 2015 to August 2018 (follow-up period was 2-32 months). Data on age, sex, type of surgery, date of surgery, date of discharge, and length of hospital stay were collected from electronic medical records. Results: We analyzed the consultation contents of 358 patients who participated in instant messaging platform consultation. Counseling was mainly related to pain (13.6%), appointment review (12.4%), activity problems (10.5%), and incision problems (8.9%). Most problems were resolved through online guidance, with 8.4% of patients requiring only outpatient treatment and 2.5% of patients requiring rehospitalization. A total of 190 patients were followed up through traditional telephone consultation; 6.8% of patients required outpatient department treatment and 7.4% were eventually re-admitted. Conclusion: The instant messaging platform consultation service effectively informs patients of potential postoperative problems and helps resolve them. It allows early detection and management of postoperative adverse events, including problems related to medication, wound, and activity, thereby effectively reducing readmission rate.

Process of Posthospital Care Involving Telemedicine Solutions for Patients after Total Hip Arthroplasty

“…Several studies describe patient satisfaction with telehealth programs [ 68 , 69 , 70 , 71 , 72 , 73 ]. Buvik et al [ 74 ] found, in a randomized controlled trial, that 86% of patients having remote consultations preferred a video-assisted consultation for the next visit.…”

Use of a Recovery Messaging Application in Outpatient Total Joint Replacement

“…A systematic review has been conducted (Bahadori et al, 2020). The remaining nine articles were observational studies categorized as prospective comparative studies, before-and-after studies, retrospective studies, and case studies (Berg et al, 2018; Dehorney & Ashcraft, 2018; Gabor et al, 2020; Glans et al, 2020; Gruskay et al, 2019; Harris et al, 2021; Lyman et al, 2020; Mascioli et al, 2021; Oosterholt et al, 2017; Zheng et al, 2019).…”

“…Researchers have established that using a fast-track, streamlined educational protocol or a recovery instant messaging, educational application can reduce the rate of readmission in patients undergoing TJR (Bahadori et al, 2020; Berg et al, 2018; Campbell et al, 2019; Gabor et al, 2020; Hussain et al, 2017; Lyman et al, 2020; Stauber et al, 2020; Timmers et al, 2019; Zheng et al, 2019). A common theme among all articles was that same-day outpatient TJR patients who received adequate and streamlined perioperative education had fewer readmissions in the 30-day postoperative period.…”

Tulane STAR (Sending Texts, Advancing Results): impact of text messaging on bariatric post-operative protocol compliance

“…There is also evidence that text message reminders can be used for pre-operative optimization for improved outcomes [12]. A number of programs involved in the post-discharge setting have been developed including postpartum care, post-operative care, and treatment of chronic heart failure and hypertension [13][14][15][16]. These programs also support the notion that text messaging with patients can serve to educate, remind about key components of care, and provide positive feedback.…”