JMIR Publications

ABSTRACT

Background:

Recently, perioperative care has gained attention for its ability to improve outcomes, reduce costs, and enhance patient satisfaction, especially when multidisciplinary support is involved. Despite these benefits, patient compliance remains low due to limited engagement in program design and practical barriers like transport, particularly for older adults. Co-designed digital health solutions offer a promising, scalable approach to delivering personalised, accessible perioperative care, with emerging evidence supporting their feasibility and effectiveness for joint replacement patients.

Objective:

This study protocol outlines the methods to address three study aims; 1) understand gaps and unmet needs, including knowledge, perceptions, barriers and acceptability, during the perioperative patient journey of hip and knee arthroplasty; 2) co-create a novel patient-centric digital care pathway (DCP) that provides education, and systematically captures patient-reported outcomes; and 3) evaluate the feasibility of implementation, appropriateness and acceptability of the pathway when tested within non-traumatic hip and knee joint arthroplasty surgical patients.

Methods:

This mixed methods co-design and implementation study will be conducted across three phases informed by the generative co-design framework for healthcare interventions. In Phase 1 (pre-design), patient interviews and journey mapping will identify perioperative care gaps to be addressed in the DCP. In Phase 2 (co-design), care gaps were collaboratively framed, and iterative prototyping of the DCP will be conducted with consumer feedback and pilot testing. In Phase 3 (evaluation) the feasibility of the DCP will be assessed Bowen’s framework. Inclusion criteria will vary across phases, focusing on people with lived experience or undergoing hip or knee joint replacement and relevant clinical or administrative staff.

Results:

NA - Study protocol

Conclusions:

This protocol enhances methodological transparency by detailing the co-design approach, strengthening the evidence base and supporting the development of a credible, transferable DCP. It addresses the lack of patient-centric perioperative programs in joint replacement care by incorporating individual needs and preferences. The digital format helps overcome access barriers, such as transport limitations, enabling patients to engage with the pathway, anywhere. Additionally, patient-reported outcome measures collected through the DCP will improve understanding of recovery trajectories following hip and knee replacements. Clinical Trial: NA - not a clinical trial