HSS@Home, Physical Therapist-Led Telehealth Care Navigation for Arthroplasty Patients: A Retrospective Case Series
HSS@Home, Physical Therapist-Led Telehealth Care Navigation for Arthroplasty Patients: A Retrospective Case Series
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DOI：
10.1007/s11420-019-09714-x
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发表时间：
2019-10-01
期刊：
影响因子：
2.5
通讯作者：
Gantha, Chandra Sekhar
中科院分区：
文献类型：
--
作者：
Fisher, Charles;Biehl, Elizabeth;Gantha, Chandra Sekhar
背景：随着全关节置换术在美国的比例持续增加，对更多基于价值的护理的推动也在不断增加。捆绑支付鼓励组织在限制护理过度使用方面具有创造性。远程医疗是护理关节置换术后患者的一种选择，同时限制成本并改善与手术团队的沟通。问题/目的我们试图确定在接受全膝关节或全髋关节置换术的患者中实施HSS@Home的效果。HSS@Home是一种使用患者现有技术的远程保健康复计划。方法在32例患者中，19例(男性9例，女性10例；平均年龄69岁)在接受手术前和术后的筛查后进入HSS@Home。进行了远程健康视频访问，其中物理治疗导航器帮助患者遵循运动和活动计划，在过渡到门诊治疗的同时解决患者的担忧。患者在出院后24小时内接受治疗，每周3次，共3周，平均11次。护理过程被记录在患者的电子病历中。结果19例患者均未再入院。所有患者都咨询了护士从业人员，主要是因为非紧急原因。患者和医生的反馈是积极的，没有发现过度使用护理。结论HSS@Home是一种有效监测髋关节或膝关节置换术后这一系列患者的方法，是一种有前景的替代生活的居家物理疗法。这一初步数据为进一步研究使用远程医疗技术为关节置换患者提供康复护理奠定了基础。
Background As the rate of total joint arthroplasties performed in the USA continues to increase, so does the push for more value-based care. Bundled payments have encouraged organizations to be creative in limiting care overuse. Telehealth is one option for caring for arthroplasty patients post-surgery while limiting costs and improving communication with the surgical team. Questions/Purposes We sought to determine the effects of the implementation of HSS@Home, a telehealth rehabilitation program that uses patients' existing technology, in patients after they had undergone total knee or total hip arthroplasty. Methods In this retrospective case series, of 32 patients referred, 19 patients (nine men and ten women; average age, 69 years) were enrolled in HSS@Home after undergoing a pre- and post-operative screening process. Telehealth video visits were conducted, wherein a physical therapy navigator assisted patients in following exercise and mobility programs, addressing patients' concerns while transitioning to outpatient therapy. Patients were seen within 24 h of hospital discharge, 3 times a week for 3 weeks, for an average of 11 sessions. Episodes of care were recorded in the patient's electronic medical record. Results There were no readmissions among the 19 patients. Nurse practitioners were consulted for all patients, predominantly for non-emergent reasons. Feedback from patients and physicians was positive, and no overutilization of care was found. Conclusion HSS@Home was a promising alternative to live, in-home physical therapy that was effective in monitoring this series of patients after hip or knee arthroplasty. This preliminary data sets the stage for further research into the use of telehealth technology to provide rehabilitative care to arthroplasty patients.