A randomized, controlled trial performed at Rush University medical center tested the impact of an automated text and video “bot” on patients undergoing hip and knee replacements. The study published in the Journal of Bone and Joint Surgery, randomized 159 patients to receive traditional perioperative education vs. support via text and video through the specially designed bot. The bot reinforced discharge instructions, communicated personal messages from their surgeons and offered access to instructional videos. Patients receiving the electronic support received 93 messages over a six week period and showed meaningful increase in daily exercise, discontinued use of narcotics 10 days earlier on average, called the surgeon’s office less often and had an improved range of motion as compared to the group receiving traditional perioperative education. The authors conclude that this messaging tool represents an easy-to- implement, patient and provider-friendly mechanism to improve outcomes in patients undergoing total joint replacements.
EHC NOTE: While the current study focused on a relatively small group of patients at a single facility, the concept of using technology to communicate postoperative care plans warrants further attention and possible application to an expanded list of procedures. The ability of surgeons to customize educational tools, delivering their own expectations for postoperative care to guide the patient during recovery is attractive from a cost and time allocation perspective. One striking result from the study is the ability to discontinue narcotics an average of 10 days earlier. Given the current focus on narcotic reduction as well as efficient use of resources, we would not be surprised to see this technology expand to other procedures associated with extensive postoperative recovery.