Automated texts aid joint replacement surgery outcomes at Rush

Knee and hip replacement surgery patients who received automated texts showed improvements in several key outcomes after their procedures.

A randomized clinical trial of 159 patients undergoing primary total knee arthroplasty and total hip arthroplasty reported fewer days on opioid pain medications, more time spent on home-based exercises, as well as higher satisfaction scores than the control group, which participated in traditional perioperative education process.

Results of the trial, conducted by the Department of Orthopaedic Surgery at Chicago’s Rush University Medical Center, were published in The Journal of Bone & Joint Surgery.

“A chatbot that texts timely, informative and encouraging messages to patients can improve clinical outcomes and increase patient engagement in the early postoperative period after total joint replacement,” says Kevin Campbell, MD, orthopedic surgery resident at Rush University Medical Center.

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In addition to decreasing narcotic pain medication use, the texts from a Short Message Service bot were credited in the study with reducing calls to the surgeon’s office.

“Patients in the control group called the office a mean of 2.6 times in the first six weeks after the surgical procedure. However, patients in the intervention group made two fewer telephone calls to the office,” finds the study. “The theoretical savings of two fewer telephone calls to the office per patient for an arthroplasty surgeon who has a mean of 350 cases per year would total around $6,125.”

With the surgical volume of total hip and total knee arthroplasties expected to increase in the next decade, the study’s authors contend that “savings in fewer calls can be paired with the increased productivity generated as clinicians redirect their time to more value-added services.”

The automated texts, sent to patients in the study through a service called STREAMD, provided recovery instructions along with encouraging and empathetic messages, personalized video messages from the surgeon, and brief instructional therapy videos.

“The content of the text and video messages reinforced the perioperative instructions and were delivered to patients at the appropriate time based on their recovery progress,” state the authors.

“As we search for practical methods to engage patients, automated messages providing education, support and encouragement create a natural and convenient way for patients to receive information, potentially improving key outcomes without placing extra time demands on the surgeon and staff,” adds Campbell, who is also co-founder and CEO of STREAMD, which provided the study’s SMS bot.