Are Digiceuticals The Missing Link To Value-Based Orthopaedics?


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With over 1 million Americans receiving total knee arthroplasty (TKA) this year, it is one of the most frequently performed orthopaedic procedures in the Medicare population. Recent research has correlated consistent interaction between the care team and patient during the extended perioperative phase with improvements in patient satisfaction and cost reductions. The emergence of digital patient engagement (DPE) platforms has increased patient communication efficiency. Utilizing data from a recently published RCT, this research reviews the impact of combining a DPE (e.g., mymobility®) with wearable technology (WT), enabling remote patient monitoring (RPM) and engagement throughout the perioperative phase. The addition of WTs enables care teams to assign periprocedural tasks and exercises (e.g., therapeutics) and monitor digitally (i.e., digiceuticals). While the RCT showed equivalence in TKA clinical metrics, it demonstrated that digitally assigned exercises and RPM were equivalent to in-person physical therapy, representing a potential reduction in the cost of care. By recasting the RCT results across the Quadruple Aim of cost reduction, quality, patient satisfaction, and care team job satisfaction, additional improvements in care emerge. Big data, collected and aggregated through mymobility, can be utilized to monitor and evaluate sub-populations of patients against a larger cohort. The application of advanced mathematical modeling (e.g., machine learning) will enable continuous process improvements in risk stratification, patient-centric advances in care pathways, and surgical procedures. As TKAs increasingly migrate toward the outpatient setting, the application of digiceuticals and digital patient engagement will play an increasing role as patients recover in-home and outside the direct view of the care team. Technological advances in WT, DPE, and improvements in perioperative care will play a critical role in driving advances toward value-based orthopaedics.



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