Opportunity
Hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries in the U.S. Patients undergoing these procedures experience substantial variability in care, outcomes, and cost during hospitalization and post-acute care.
Patients discharged from hospitals to a rehabilitation or nursing facility have higher costs but not necessarily improved outcomes. Readmission after hospitalization is substandard and costly for patients and health systems.
Intervention
HomeConnect+ is an automated hovering program designed to improve the quality and value of care for patients undergoing hip and knee replacement surgery.
Patients are enrolled in the program before surgery and monitored for 45 days afterward. The intervention supports recovery by monitoring movement with wearable activity trackers, sharing post-operative goals and milestones via text message, and tracking patient pain scores. Users can also readily connect with their care team if they have questions or concerns.
HomeConnect+ is powered by Way to Health. Way to Health enables the HomeConnect+ team to rapidly validate how additional program features such as gamification and social support might improve patient outcomes and care value.
Impact
During initial pilots at Pennsylvania Hospital and Penn Presbyterian Medical Center that included patients at intermediate risk of discharge to a facility, only 3 percent of HomeConnect+ patients were readmitted to the hospital after surgery, compared to 12 percent of those not enrolled in the program.
While the pilot showed a fourfold decline in readmissions, the team did not observe an increase of discharges home after surgery or improvement in physical activity rates post-discharge. Ongoing implementation of the HomeConnect+ program is underway, and there are plans to incorporate additional messaging while expanding to a broader risk profile of patients.
