The proven dimension in remote patient assessment
in the critical weeks after orthopaedic surgery
Early supported patient discharge
potentially on the same day as surgery5, thereby reducing in-stay time and cost and improving patient flow
The NHS is under significant pressure from central and devolved governments to improve efficiency and productivity, empower patients to shape and manage their own health and care and to improve health outcomes1.
The number one priority of the NHS’ 10 Point Efficiency Plan is to free up between 2,000 and 3,000 hospital beds2 by accelerating the discharge of patients who are otherwise fit and whose care would more appropriately be delivered in other settings. With around 200,0003,4 hip and knee replacement procedures performed annually in the UK and demand set to rise due to lengthening life expectancy and growing obesity rates, any reduction in the typical in-stay duration of 2-4 days would have a significant, positive impact on NHS efficiency and productivity.
Enhanced recovery programmes are, however, leading a paradigm shift in the post-operative physical rehabilitation of orthopaedic patients. With BPMpathway, patients can be discharged as early as the day of their surgery to continue their rehabilitation at home under self-direction, with clinicians remotely assessing their recovery. This has the potential to improve patient flow, freeing up beds by reducing the length of a patient’s hospital stay and cost to as little as a single day. Furthermore, there is the additional benefit of minimising patients’ exposure to the additional complication of hospital-acquired infections.
BPMpathway is a cost-effective remote patient assessment platform that supports orthopaedic patients through their preparation for surgery at enhanced recovery joint schools, during the acute hospital phase and crucially supports them throughout their rehabilitation, whilst at the same time providing clinicians with the vital data needed to assess their on-going recovery progress.
Download the product description and discover more about BPMpathway. To arrange a demonstration, please click here.
BPMpathway has the potential to deliver massive benefits for NHS trusts, clinicians and patients through:
- Efficiently-targeted care
across the critical weeks post-surgery by prioritising resources to those patients needing them the most within an expanded group of recipients
- Improved patient motivation and engagement
with feedback, reassurance and encouragement playing an important role in improving patient outcomes8 and PROMS scores
- Enhanced patient recovery programmes
by harnessing technology and innovation to create personalised post-operative support7,10
- Decreased readmission rates
through the early identification of potentially developing complications6 that may go unnoticed by the patient
- In partnership with
‘BPMpathway has the potential to be a cost-saving intervention for the NHS by improving efficiencies in the current system of monitoring patients by reducing number of outpatient appointments, reducing rehabilitation time, improving patient’s adherence to rehabilitation schedules and increasing confidence in exercise regimes leading to improved health-related quality of life.’
What is BPMpathway?
Before a patient leaves hospital or during the pre-operative period, the clinician uses BPMpathway to create a personalised post-operative support programme to meet the patient’s individual needs, which they can undertake in the comfort of their own home. The programme, which a patient will typically be asked to undertake three times a day, is a combination of tests to determine pain, range and quality of motion and physiotherapy exercises to help with rehabilitation.
During a test, a wireless BPMpro sensor worn on the limb under test streams data to the BPMpathway app on the patient’s tablet displaying the results on a live animated avatar, recording them for immediate on-screen graphical comparison. The data is also simultaneously transmitted automatically via the Cloud to the clinician to review progress and recovery trends.
Easy-to-understand instructions and test set-up and exercise videos help the patient with their programme as the software progresses them through a defined path of what they need to do throughout the rehabilitation process. The patient-centric system is simple to use without any connection cables or needing to be connected to a TV. Advanced mathematics enable the use of a single sensor with a simple strap attachment and compensate for slight placement inaccuracies. The patient UI has been designed to be highly-intuitive and includes instruction videos, automated test start/stop and pain reporting.
Download the product description and discover more about BPMpathway. To arrange a demonstration, please click here.
Remote patient assessment
The typical approach adopted by many hospitals is to provide all patients with the same post-operative support package. These support resources are, however, under pressure like any other area of healthcare and need to be prioritised.
With the comprehensive progress data collected by BPMpathway, clinicians can tailor an orthopaedic patient’s post-operative support to meet their individual needs, without necessarily waiting for a face to face consultation. In other words, a personalised recovery programme to support the patient throughout the rehabilitation process, helping them to get back to their normal life as quickly as possible.
Using BPMpathway, clinicians can remotely review the patient’s post-surgical recovery. When they’re progressing well at home, the clinician can decide that the patient can continue their rehabilitation in the comfort of their own home, thereby freeing up the resources that would otherwise have been allocated to them for those who need them most.
In the case of those patients who are struggling with their recovery, BPMpathway provides a means of identifying the potential need for early intervention and a communication link between the patient and clinician to establish whether they need to be prioritised for outpatient support.
References
- The Government’s Revised Mandate to NHS England for 2017-18
- Next Steps on NHS 5 Year Forward View – Funding and Efficiency
- Scottish Arthroplasty Project Annual Report 2018
- National Joint Registry 15th Annual Report 2018
- Mihalko W, Saleh KJ. Outpatient Total Knee Arthroplasty Are We There Yet? (Part 1). Orthop Clin N AM. 2018. Page 1-6.
- Mamarelis G, Sunil-Kumar KH, Khanduja V. Timing of manipulation under anaesthesia for stiffness after total knee arthroplasty. Ann Transl Med. 2015 Nov;3(20):316.
- Shukla H, Nair SR, Thakker D. Role of telerehabilitation in patients following total knee arthroplasty. J Telemed Telecare. 2016 Feb 2.
- Hibbard J, Greene J. What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs. Health Affairs 32, no.2 (2013):207-214.
- Poster Abstract 20th March 2015, East Sussex Healthcare NHS Trust, R Mills, M Coupe-King, K Weatherly, K Miles, J Buchanan
- Piqueras et al. Effectiveness of an interactive virtual telerehabilitation systems in patients after total knee arthroplasty. J Rehabil Med. 2013; 45: 392-396.
- Snow R, Granata J, Ruhil AV, Vogel K, McShane M, Wasielewski R. Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement. J Bone Joint Surg Am. 2014 Oct 1;96(19):e165.
- Health Quality Ontario. Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis. Ont Health Technol Assess Ser. 2005;5(8):1-91.Pozzi F, Snyder-Mackler L, Zeni J. Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med. 2013 Dec;49(6):877-92.
- Pozzi F, Snyder-Mackler L, Zeni J. Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med. 2013 Dec;49(6):877-92.
- Clinical and cost implications of inpatient versus outpatient orthopaedic surgeries: a systematic review of the published literature. Dennis C. Crawford, Chuan Silvia Li, Sheila Sprague, Mohit Bhandari. Orthopaedic Reviews 2015; volume 7: 6177.
- Effectiveness of an Automated Digital Remote Guidance and Telemonitoring Platform on Costs, Readmissions, and Complications After Hip and Knee Arthroplasties. Benjamin I. Rosner, MD, PhD, Marc Gottlieb, MPA, William N. Anderson, PhD. The Journal of Arthroplasty 2 December 2017
- Improved early outcome after TKA through an app-based active muscle training programme—a randomized-controlled trial. Sebastian Hardt Matthias R. G. Schulz Tilman Pfitzner Georgi Wassilew Hauke Horstmann Emmanouil Liodakis Thomas Sanjay Weber‑Spickschen. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018.
- Sensor Positioning Influences the Accuracy of Knee Rom Data of an E-Rehabilitation System: A Preliminary Study with Healthy Subjects. Carlos J. Marques, Christian Bauer, Dafne Grimaldo, Steffen Tabeling, Timo Weber, Alexander Ehlert, Alexandre H. Mendes, Juergen Lorenz, Frank Lampe, Faculty of Life Sciences, Hamburg University of Applied Sciences, 15 April 2020
- Sadozai Z, Bhuskute N, Cooper Dm, Walsh G. The Post Covid-19 Era: Reducing Hospital Stay And Face To Face Contact With Digital Day Case Pathways. Bask Spring Congress; 2021 May 18-19; Bristol, United Kingdom.
