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Using Telehealth Remote Monitoring in Orthopedics

Posted by Michael Greiwe, MD | November 16, 2018 |
Michael Greiwe, MD

Orthopedic surgery is changing. Some of the changes are centered on adjusting to what Becker’s calls the specialty’s “most pressing challenges.” Other changes are driven by consumer demand and technology innovation. No matter the driver, it’s clear that the orthopedic practice of the next decade will look radically different from today.

One of the biggest changes is a new wave of technology that is widely perceived as changing how we provide care. Telemedicine in the form of remote monitoring is one of the innovations changing how we treat patients. Healthcare IT News predicts the market will soar past the $34 billion mark by 2020. What factors are reshaping how our practice conducts the business of orthopedic care? How will remote monitoring in orthopedics change care delivery and what are the benefits?

Factors Changing the Orthopedic Practice

Healthcare is facing unprecedented challenges affecting every specialty. In orthopedics, we are facing an aging Baby Boomer population that will drive up demand for total hip and knee surgeries. Becker’s says the National Institute of Health (NIH) numbers show a 174% increase in the demand for total hip replacement, while total knee arthroplasties will expand by 673% by 2030.

While this may sound like a boon for the orthopedic practice, in fact, it is expected to put more pressure on a dwindling workforce. The U.S. Department of Health and Human Services predicts a shortage of more than 5,000 orthopedic surgeons in the field, with the hardest hit areas including rural communities who are already struggling to find enough providers.

These shortages will continue to limit the amount of face-time providers spend with patients. The logical effect will be that patient satisfaction scores under value-based care will suffer. Becker’s suggests,Value-based care places more focus on the patient, and orthopedic surgeons face a juggling act to comply with reporting requirements while also giving patients ample one-on-one contact.”

While this paints a murky picture of the future state of orthopedic surgery, a new way of thinking about the specialty sheds light on how telehealth technology can be harnessed to improve workflows and patient satisfaction.

Remote Monitoring Telehealth in Orthopedics

MedCity News shared the personal experience of one orthopedic surgeon’s journey through the profession and how surgical techniques, best practices, and outcomes have changed. The author, Marshall Steele, M.D., recounts 40-years of the profession culminating in what he believes will be the future of the orthopedic surgical practice: Telehealth.

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Dr. Steele suggests that the new value-based care paradigm will drive “Overall costs, patient experience and outcomes,” including managing costs after the patient leaves the surgical care unit. He predicts a faster care delivery mechanism that includes fewer in-patient days and more at home care. He suggests that a subset of telehealth technology, remote monitoring would be the best way to evolve patients and their caregivers from “passive recipients of care to active participants.” Steele laments that every physician seeks this goal but few have achieved it.

Telehealth, he concludes, is the answer. He suggests these tools, accessible at all times from a laptop, desktop, or smartphone provide a clear way to engage the patient by providing them with consistent aftercare instruction, educating them on their progress while ensuring better compliance. The workflow for orthopedic surgery patients could include:

  • When surgery is scheduled, patients are provided a link to a telehealth web portal and are taught how to use it.
  • The patients would select an “aftercare coach” and provide them with their contact information.
  • Post-surgically, the patient and coach would receive written and video education as well as Q&A checklists to teach aftercare best practices. These checklists would include action steps and timelines for completing rehabilitation.
  • Ongoing progress would be monitored remotely with an alert system that flags more serious issues back to the surgeon or a nurse manager and less serious issues to the clinical coaches.
  • Video conferencing could be used for wound care, eliminating the need for some onsite inpatient visits.
  • Patient outcomes would be tracked continuously from this portal and remote family members could even be looped in with the permission of the patient.

Dr. Steele suggests these changes to the orthopedic surgical workflow would increase patient satisfaction and health outcomes through the use of digitally connected continuous monitoring tools. It could also cut costs while improving patient compliance.

While the article suggested on orthopedic surgeon’s take on the future state of the specialty, there is increasing evidence that telehealth will have a positive impact on the future state of healthcare.

Orthopedics Today Predictions for Telehealth

An article in early 2018 from Orthopedics Today suggested how telehealth could benefit the orthopedic surgery patient:

An infected hip or knee is an intimidating and stressful potential complication after a joint replacement…But this often involves surgery with frequent trips to a central location for follow-up, and travel expenses and planning adds to patient and family stress.

Even when a patient can access the orthopedic surgeon or the orthopedic team with a phone call, it is difficult to evaluate a patient by phone who has concerns about a wound or function after surgery. In the next few years, a telemedicine visit could replace an office visit and contain health care costs by preventing unnecessary trips to the ED, reduce hospital readmissions and improve patient satisfaction by catching problems earlier.

While telehealth cannot take the place of all orthopedic visits, it is clear that the thinking is shifting toward easing the burdens of provider shortages, higher costs, and an increase in patient-centric value-based reimbursement, with this technology. Other industries and even other healthcare specialties have taken advantage of digital technology to streamline workflows. Telehealth gives us a way to make our services more cost-effective and patient-centered.

It’s for these reasons that OrthoLive developed a telehealth application geared specifically for the orthopedic provider. In the words of Orthopedics Today, “Orthopedic surgeons offer vital and unique service, and we all need to work harder to make these services more accessible to patients who need them.”

Contact OrthoLive for a free demo of our telehealth platform and start to envision the next steps for your practice.

Topics: "telehealth", "telemedicine", orthopedic practice, digital trends, 2018 trends

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