This study evaluates the addition of an automated physician-specific text-messaging (SMS) bot in patients undergoing total joint arthroplasty. Half of the patients received the traditional perioperative education and instructions (control group), while the other half were enrolled in their physician's SMS bot (intervention group).
In an era of value-based reimbursement and high-volume surgery, the patient experience is becoming increasingly important. Despite publicized efforts to place a greater emphasis on patient-centered care, patients often report poor access to their physician, lack of effective perioperative education, and frustration as their care is commoditized. A text-messaging (SMS) bot has the potential to help fill some of these voids. Bots are computer programs that are inherently automated to simulate human-like tasks. While a physician may wish he or she could contact each of their patients daily, it would be an impossible undertaking for most. An SMS bot could make daily contact possible by automating it, potentially improving patient education and engagement before and after surgery. Standard SMS has been previously reported to be an effective means for delivering timely information, increasing patient compliance and outcomes (medication adherence, decrease surgical infections with antiseptic showers), and reaching a socioeconomically diverse patient population. Further benefits may be seen with an SMS bot due to its automated capabilities.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
159
Patients will be enrolled in an 'Automated Text Messaging (SMS) Bot (intervention group)' which is a computer program that sends patients timely reminders, instructions, and videos to help them prepare and recover from surgery.
Patients will receive the 'Routine perioperative education \& teaching (control group)' and will not be enrolled in the physician-specific SMS bot.
Time Participating in Home-Based Exercises
Stretching, strengthening, and other rehab-specific exercises counted toward their home-based exercises, while walking was excluded.
Time frame: over a six-week time period after arthroplasty surgery
Knee Range of Motion
Degrees of flexion and extension of the operative knee will be measured at 6 weeks after surgery.
Time frame: over a six-week time period after arthroplasty surgery
Use of Narcotics/Opiates
Medications designated as "narcotics" included any medications that contained: hydrocodone, oxycodone, codeine, morphine, or tramadol. Patients were instructed to record their responses during the same two-hour window each day in a daily diary.
Time frame: over a six-week time period after arthroplasty surgery
Visual Analog Scale (VAS) Mood Score
VAS mood scores were collected from patients on the standard ten-point validated scale. If a patient circled two adjacent numbers on their daily diary, an average of the two numbers were assigned for that day. Minimum score 0. Maximum score 10. Higher score is worse outcome (more pain).
Time frame: 6 weeks post-operative
Calls to the Office
The number of patient calls to their physicians office were tracked and recorded.
Time frame: over a six-week time period after arthroplasty surgery
Number of Participants Reporting Satisfaction With Instruction Clarity
Patients were asked to fill out a satisfaction survey six weeks after surgery
Time frame: over a six-week time period after arthroplasty surgery
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Visits to the Emergency Department (ED)
The number of visits to the ED were tracked and recorded.
Time frame: over a six-week time period after arthroplasty surgery