PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL

Baker P, Martin R, Clark N, et al. PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL. Orthop Procs. 2022;104-B(SUPP_7):11-11. doi:10.1302/1358-992X.2022.7.011

Baker, P., et al. “PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL.” Orthopaedic Proceedings, vol. 104-B, no. SUPP_7, 2022, pp. 11-11., https://doi.org/10.1302/1358-992X.2022.7.011

Baker, P., Martin, R., Clark, N., Nagalingham, P., Hackett, R., Danjoux, G., McCarthy, S., & Gray, J. (2022). PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL. Orthopaedic Proceedings, 104-B(SUPP_7), 11-11. https://doi.org/10.1302/1358-992X.2022.7.011

Baker, P., Martin, R., Clark, N., Nagalingham, P., Hackett, R., Danjoux, G. et al. (2022) “PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL.” Orthopaedic Proceedings, 104-B(SUPP_7), pp. 11-11. Available at: https://doi.org/10.1302/1358-992X.2022.7.011

Baker, P., R. Martin, N. Clark, P. Nagalingham, R. Hackett, G. Danjoux, S. McCarthy, and J. Gray. “PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL.” Orthopaedic Proceedings 104-B, no. SUPP_7 (2022): 11-11. https://doi.org/10.1302/1358-992X.2022.7.011

Baker P, Martin R, Clark N, Nagalingham P, Hackett R, Danjoux G, et al. PATIENT EDUCATION AND SUPPORT USING A ‘DIGITAL JOINT PATHWAY’ MODEL. Orthop Procs. 2022 Jul 1;104-B(SUPP_7):11-11. https://doi.org/10.1302/1358-992X.2022.7.011

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Abstract

Introduction

The NHS long term plan endorses ‘personalised’, ‘digitally enabled’, ‘out of hospital’ care. Multiagency guidance (CPOC(2021)/NICE(2021)/GIRFT(2021)/NHSX(2021)) advocates an integrated ‘pathway’ approach to information sharing, shared-decision making and patient support. Digital solutions are the vehicle to deliver these agendas.

Methods

In 2018 we developed a digital joint pathway (DJP) spanning the surgical care pathway (prehabilitation to rehabilitation) using the GoWellHealth platform. Patients listed for joint replacement are offered the DJP as routine care. Activity and engagement are monitored using the DJP data library. We sought to evidence our DJP by assessing patient engagement, experience and outcomes (OKS/EQ5D/Readmission).

Results

Engagement

Consecutive cohort of the first 1195 patients registered. Activation rates were >85% and >70% viewed content within the DJP (median=15 access/pt; mean=83 minutes on DJP/pt). Engagement was similar irrespective of age and gender (p=NS). Older patients preferred to access via a computer.

Experience

Qualitative interviews (n=14) demonstrated patients felt the DJP impacted positively on their health behaviours and contributed to their recovery. They spoke positively about the use of technology and the accessibility of the DJP.

Outcomes

Comparison of patients on the DJP versus those not on the DJP using adjusted regression models demonstrated improved EQ5D=0.070 (95%CI=0.004-0.135,p=0.04), OKS=5.0 (95%CI=2.2-7.8,p<0.001) and readmission rates (3.6% versus 5.6%,p<0.01) for DJP patients.

Conclusions

A DJP model for information delivery and patient support, across the entirety of the surgical pathway, is feasible and demonstrates high levels of patient engagement, experience and improved patient outcomes.