Virtual Pre-Operative Education for Total Joint Replacement: Equivalent Outcomes & Lower Costs

The linear growth in the annual volume of total joint replacement (TJR) in the United States is expected to continue. Predicted annual volumes for total hip replacement (THR) by 2025 and 2030 are 692,000 and 850,000. Similarly, for total knee replacement (TKR), predicted annual volume for 2025 and 2030 are 1,272,000 and 1,921,000, respectively.

To meet this expected increased demand, the Center for Medicare and Medicaid Services (CMS) and the Institute for Healthcare Improvement (IHI) implemented alternative payment models, with the intent to improve outcomes while lowering the per capita cost for TJR procedures. Recent literature demonstrates that lower costs and higher quality of care could be correlated. For instance, a number of studies have shown that discharging patients directly home leads to lower rates of readmission. Many of these studies identify preoperative patient education as a crucial element of the TJR clinical pathway and suggest that preoperative education should be done in conjunction with all other interventions.

Force Therapeutics has taken the concept of preoperative patient education a step further and begun to offer it in a virtual setting. The ultimate goal of virtual preoperative education is to 1) provide patients with key information specific to their procedure, regardless of their geographic location and 2) give valuable hours back to FTEs – e.g. case navigators, nurses, nutritionists, physical therapists, social workers, etc.

In this paper, we aim to 1) establish that Force’s virtual preoperative education class for joint replacement delivers equivalent outcomes (both in terms of functional outcomes and patient satisfaction) against a traditional in-person class and 2) highlight potential cost savings from switching from in-person to virtual preoperative education by looking at one of Force’s client hospital systems as an example.

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Sources:

• http://www.jrheum.org/content/early/2019/04/09/jrheum.170990
• https://qpp.cms.gov/apms/overview, https://www.ncbi.nlm.nih.gov/pubmed/19150214
• https://www.ncbi.nlm.nih.gov/pubmed/24183369
• https://www.ncbi.nlm.nih.gov/pubmed/10030179
• https://www.ncbi.nlm.nih.gov/pubmed/14572947