Building an integrated digital-health solution
Digital technologies can capture and address patients’ clinical, physical, and behavioral parameters throughout the episode of care, in an objective and unobtrusive manner. The service experience design methodology ensures that needs of all stakeholders are clearly understood before designing the solution. Preliminary findings reveal the need for a digital solution to focus on the use of wearable devices and smart phones by patients, and digital dashboards by physicians. These will enable frequent capture of psycho-physiological data from patients and provide analytics to physicians. With this approach, a typical implementation of a digital-health solution consists of elements such as:
Wearable devices and sensors: To monitor range of motion (RoM) and gait in real time–before and after surgery.
Digital assistance apps: To collect information about patients’ expectations on surgery outcomes, experience of pain, and mental health states before and after surgery. These also help to continuously monitor progress, enable behavioral interventions for stress and anxiety, and ensure adherence to rehabilitation regimen. Moreover, patients can be educated on the dos and don’ts through articles and videos on their health conditions, surgery, and rehabilitation. These are also effective tools for patients to interact with clinicians for queries, guidance, and appointments. Additionally, features of community support aid patients to digitally connect with other patients with similar ailments to exchange best practices on recovery.
Clinicians’ portal: To assess activity levels, gait and RoM, and to monitor PROs pre-surgery. This also aids to monitor RoM, wound and pain post-surgery, and the level of adherence to the patient’s rehabilitation regimen.
Such a solution (Figure 4) offers surgeons near real-time access to precise information, without frequent in-person patient evaluation. In the pre-surgical phase, such information helps surgeons establish an objective baseline for outcome evaluation. It also enables timely interventions post-surgery, when a patient’s clinical progress or adherence to a rehabilitation regimen is below par.
For patients, it provides a convenient means to report RoM, pain and anxiety. It also provides accurate recovery status, education, and personalized behavioral interventions. Such a holistic solution can reduce the need for in-person interactions between patients and clinical staff and make necessary in-person interactions far more focused and efficient.
Driving large-scale adoption
We believe that such a digital-health solution will provide hospitals and surgeons with complete, timely and patient-centric information to help treat patients far more effectively. This has the potential to significantly improve patient satisfaction. While joint replacement is one example, the concept has considerable potential to enhance outcomes of several other surgical procedures. Clinical validation and adherence to relevant regulatory guidelines will be a prerequisite for large-scale adoption of such solutions. A word of caution, though such solutions must address concerns of privacy, safety, and efficacy, and adhere to best practices such as the WHO’s guidelines for digital-health solutions.