9 JAN - FEB, 2021individually called CareCards, which are spaced out over an extended timeline.Patients receive their first CareCards four weeks prior to their surgery date, and their final CareCards one year after their surgery date. The patient is also able to communicate vital information back to their care team through interactive forms and surveys.Maximizing Patient CompliancePatients are enrolled in the Online CarePath at the same time they are scheduled for their surgery. Palomar understands that patients are more likely to be compliant when their surgeon directly instructs them to do something.Therefore, all CareCards are signed by their surgeon and include the surgeon's photo. Patients are also encouraged to add additional caregiver's contact information so that their care circle can receive the same content.Once activated, the patient will continue to receive CareCards specific to their needs, based on the pre-determined timeline. Each CarePath can include CareCards that are specific to a patient's condition, like diabetes. Two surveys are administered before surgery, a Discharge Assessment Form that is designed to remove barriers to a timely return to home (e.g., Durable Medical Equipment, transportation), and a baseline Patient Reported Outcome Measures (PROM). After surgery, the patient completes a survey measuring their perception of preparedness. They continue to complete their PROMs at 90-days and one-year post-operatively. If any responses are flagged as concerning, the care team is alerted, and a call can be made to the patient or their designated caregiver.Measuring CarePath's EffectivenessA concern in implementing an Online CarePath is whether patient participation rates would be high enough to justify the added resources needed to support the platform, especially given the older ages of total joint replacement patients. Of the 455 patients that were enrolled over an eight-month period, 375 activated their accounts (82.4 percent). Activation rates by patient gender and age were evaluated. Men had a higher probability of activating their CarePath than women. Patients ranged in age from 28 to 89, with the average age of a joint replacement patient as 68.7 and the average age of a spine fusion patient being 63.3. The 80+ age cohort expectedly had the lowest activation rate, but at 76 percent, this cohort remained engaged at a rate higher than was expected.To evaluate the effectiveness of the Online CarePath, patients were sorted into comparison groups (including patients who didn't utilize the tool). Total Joint Replacement patients who activated the tool experienced 15 percent lower lengths of stay over the patients who were enrolled but did not activate their accounts. Spine Fusion patients who activated the tool experienced 30 percent lower lengths of stay; 98 percent of those that activated felt prepared for their surgery.Since the pandemic began, Palomar has enrolled in 195 new patients in the Online CarePath. The overall activation rate has increased to 85 percent, and the rate of patients stating they felt prepared for their surgery improved to 99 percent. With a small investment in time and resources, the Online CarePath met its goal of preparing patients for a quick and safe return home after total joint replacement or spine fusion. Originally conceived of as a complement to in-person education, the Online CarePath has proven to be invaluable since the coronavirus pandemic forced Palomar to cancel in-person pre-surgery classesBrian Cohen
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