JMIR Publications

ABSTRACT

Background:

Current assessment of recovery after total hip or knee replacement is largely based on measurement of health outcomes through self-report and clinical observations at follow up appointments in clinical settings. Home activity-based monitoring may improve assessment of recovery by enabling collection of more holistic information on a continuous basis.

Objective:

To a) introduce orthopaedic surgeons to time-series analyses of patient activity data generated from a platform of sensors deployed in homes of patients who have undergone primary total hip or knee replacement, and b) understand the potential role of this data in post-operative clinical decision making.

Methods:

Focus groups and interviews with 9 orthopaedic surgeons. Data were collected using an action-based approach and analysed thematically.

Results:

The home data offered a real opportunity to more objectively characterise patients’ recovery from surgery. However, orthopaedic surgeons highlighted the considerable difficulty in navigating large amounts of complex data within short medical consultations with patients. Orthopaedic surgeons thought that a proposed dashboard presenting information and decision-support alerts would fit best with existing clinical workflows.

Conclusions:

From this, the following guidelines for system design were developed: Guideline 1: Minimise the risk of misinterpreting data, 2: Express level of confidence in data, 3: Support clinicians in developing relevant skills because time series data is often unfamiliar, 4: Consider the impact of patient engagement with data in the future.