Steven Barnett, MD, Orthopedic Surgeon/Researcher at Hoag Orthopedic Institute talks about an app for iPhone’s and IWatch that helps patients with recovery after post hip and knee replacement.
Interview conducted by Ivanhoe Broadcast News in May 2019.
Let’s talk a little bit about the app, just the theory behind it. Briefly explain what it does.
BARNETT: It’s a concept that was developed between both Zimmer-Biomet and Apple to look at ways that they could leverage new technology and use this in the peri-operative period for hip and knee replacement patients in an effort to better prepare them for surgery as well as assist them in their post-operative rehabilitation.
The thought being that there’d be better compliance if it’s at home?
BARNETT: Really the concept is that patients will be able to manage and engage in their own therapy daily without requiring a home visit. But more importantly utilizing the paired iWatch that the patient wears to record vital statistics like distance traveled, heart rate, and various data points, that allows us as the surgeon and practitioner to track how they’re doing remotely. The application is very robust. We can log into these patients accounts daily, see how far they’ve walked, see if they’ve done their exercises and it allows us to keep closer tabs on them especially in that immediate post-operative period.
How soon after surgery do they start using it?
BARNETT: The application is utilized even in the preoperative period and helps the patient prepare for suregey. Once the surgery is completed and the patient is discharged home they start using the physical therapy portion immediately. These days a significant portion of joint replacement surgeries are performed as an outpatient. So, this allows them to get involved with therapy immediately and again allows us to track their progress very specifically for each patient.
What exactly is on the app?
BARNETT: So, the app has many different modules. Obviously an important one is the videos of the actual exercises they’re going to be doing, but there’s also frequently asked questions as well as bullets that will pop up daily reminding them about certain things that they need to be conscious of. Also, in the preoperative period, certain goals and milestones they need to reach in their preoperative preparation process.
What would be in the pre-op part?
BARNETT: Joint replacement patients need to participate in several preoperative steps including blood work analysis, medical clearance, and apre-op education class that they attend at the hospital. So, the app just gives them subtle reminders as a checklist to make sure that nothing will delay their procedure.
How long’s the trial been going on?
BARNETT: We started last fall in November. There are 20 different sites around the country and the first patient was enrolled late summer, early fall.
Is it too soon to see any kind of results or compliance or anything like that?
BARNETT: Actually, the compliance has been quite good in the pilot portion of the project that we’ve been involved with. Again I think because we have this access to their daily data and that allows us if we see that maybe the patient hasn’t logged into their app for a few days or they’re struggling with their exercises, we can call them and get them into the office and you know have a one-on-one discussion with how things are going. So, we can monitor them very closely with this.
It seems like a great idea a time saver for both you and for the patients.
BARNETT: Well I think we have the technology available to us now to monitor patients remotely. And this is an effort to leverage that technology so we can hopefully benefit patients going forward.
How soon until Joe on the street might be able to get something like this?
BARNETT: Widespread availability is going to be a couple of years because we have to run through the study and enroll a certain number of patients and then track and make sure A, that it’s effective and B, that it’s safe before it’s released to a broader population.
Cost is the watch and the phone?
BARNETT: The way the study works is the watch is provided to the patient, which they utilize for a year. The therapy exercises don’t go on for a year, but the patients are free to use the app as much as they want after they’ve completed the therapy portion of it.
How long is the therapy portion?
BARNETT: Six to eight weeks.
END OF INTERVIEW
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