Kneed help? Patients perceived value of apps to support their - - PowerPoint PPT Presentation

Kneed help? Patients’ perceived value

• f apps to support their rehabilitation

Geremy Farr-Wharton, Jane Li, Jill Freyne, Sazzad M. Hussain, Emily Brindal July 2018

HEALTH AND BIOSECURITY

Activate TKR

Technology assisted healthcare Digital

• rthopaedic

care models Wearable technology integration Patient Empowerment

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• TKR Preparation & Recovery Program
• Behavioural coaching
• Practical information
• Personalised physiotherapy plans
• Physiotherapy video library
• Checklists
• Self monitoring tools
• Integrated Activity Tracking with Garmin

VivoSmart HR – sleep, steps, stairs

• Pain and ROM reporting
• Gamified rewards for compliance and

achievements

Activate TRK | Jill Freyne

Activate TKR Platform – Patient App

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Activate TKR Platform – Clinician Portal

• Physiotherapists &

Surgeons

• Review patient status
• Algorithms identify patient

data in need of review

• Traffic light system

highlights algorithm

• utputs
• Search, filter, archive

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Validation & Testing

• Randomised Control Trial
• 150 participants
• Multi-site
• 3 Private Hospitals (2 x NSW + 1

x Qld)

• 1 Public Hospital (1 x Qld)
• Unblinded
• 16 week Intervention

Activate TRK | Jill Freyne

Clinical Efficacy Acceptance & satisfaction Economic impact

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Qualitative Evaluation

A focus on the Patient’s TKR Journey and Experiences

• Activate TKR Usability, Impact and Compliance
• Usefulness of Support Tools/educational content – preoperative and

postoperative (a keen focus on videos to guide physiotherapy exercises and rehabilitation)

• Self monitoring recovery and pain progression, and when particular

activities are again achievable

• Improving clinical communication and information flow between the

patient and their clinician team

• Understanding technical and other unforeseen issues experienced by

patients

• Exploring patient suggestions for system improvements to enhance future

patient experiences

• Interview transcripts underwent Latent Coding with two

researchers to derive emergent themes for NVivo Analysis.

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Initial Findings

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Activate TKR played a significant role in prompting, reminding and motivating at-home physiotherapy

“Even I who hate exercise knew that I had to do it and that’s it” “Probably the exercise program, I found that really beneficial” “I wouldn’t have kept doing it without the app. […] Just the fact that it's there to remind you every day and if I forget […] it reminded me at night. For me just having something like that is a great help, because it's very easy not to do exercises, but if I’ve got something there saying this is what you do and I go in and make sure I do them”

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Initial Findings - Activate TKR has played a significant role in prompting, reminding and motivating at-home physiotherapy (continued…)

“Well you know it’s really easy to get lazy and

because you know you are sort of being watched, […] you sort of go oh I better do that I better do that – so you do tend to make sure you do it” “I am answerable to this thing so I better just get

• n with it – it was like having a boss in the house

all the time” “It was acting as a personal coach for me”

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Enhanced patient-clinician communication flow

“yes well you know you sort of feel like that you are on the same wavelength you understand where you are and what you are trying to do” “And (they - Physiotherapist*) changed the exercises a few times too because (they*) said oh well you are up to this now, I’ll change this and tweak that and so on” “And some of the exercises I found were just

• aggravating. […] (I explained) the difficulties

that I was having and they altered the exercise programme on the App”

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Enhanced patient-clinician communication flow (continued…)

“I knew (they – Physiotherapist*) had the data, I knew (they*) were getting my pain, like (they*) said (the me during a consultation) “you don’t seem to have had much pain, how are you going with pain”, so.” “Yeah, (they - Physiotherapist) were keeping track of it […]. I think he kept a pretty close eye on what I was doing and gave me more exercises and stuff like that”

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Participant Suggestions for Future Inclusion

“I don't know where I stand in comparison to other people at 3 months, you know what I mean, am I average, am I below average, have I excelled, that will tell me if I’ve done things well” “I reckon you virtually have to right off 3 months of your life, because your focus for 3 months […] , you’ve got to get up and down the stairs, you’ve got to do this – and it does – it tends to take over your life” “I was under the impression that after 6, 12 weeks I’d be right, it's not true”

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Activate TKR Qualitative Analysis Continues

Clinician Evaluation

• 10 Clinician Interviews (Surgeons

& Physiotherapists) – exploring their value of Activate TKR

Patient Evaluation ….

• Patient Interviews
• Carer Interviews – exploring how

to best support aspects of the TKR carer role through Activate TKR

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At CSIRO we do the extraordinary every day.

We innovate for tomorrow while delivering impact today – for our customers, all Australians and the world.

Activate TRK | Jill Freyne

For more information contact: Dr Jill Freyne, Project Leader t +61 2 9372 4453 E jill.freyne@csiro.au

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