Can technology optimise the pre-operative pathway for elective hip and knee replacement surgery: a qualitative study
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RESEARCH
Open Access
Can technology optimise the pre-operative pathway for elective hip and knee replacement surgery: a qualitative study Faraz Sharif1* , Ammar Rahman1, Emma Tonner2, Hanad Ahmed3, Iqraa Haq1, Rami Abbass1, Shad Asinger1 and Magda Sbai4
Abstract Background: An ageing population has resulted in a rise in the number of hip and knee replacement surgeries in the UK. The pre-operative pathway is plagued with issues causing long delays and cancellations. Virtual healthcare technologies have a growing evidence base to help solve these issues. One problem of implementing these technologies is the resistance to change mentality from healthcare professionals. By getting their opinions on the place of these technologies within the pre-operative pathway, a united front can be formed to help deliver change. Methods: Sixteen semi-structured interviews were conducted with key stakeholders within the orthopaedic preoperative pathway at Imperial College Healthcare NHS Trust. General topics included the different technologies that could be used within the pathway, their uses and associated benefits and problems. Interviews were audiorecorded, before being manually transcribed and then analysed to form categories and themes. Results: Various uses, benefits and problems were identified by healthcare professionals for each modality of technology. E-forms were seen as a high reward, low-risk intervention. Remote patient monitoring and teleconsultations had their bonuses, but feasibility was a primary concern. Web-based interventions were seen as an intervention of the past, whereas virtual reality was seen as perhaps being ahead of its time. M-health was very positively viewed due to its all-encompassing nature. Digital illiteracy emerged as a consistent problem for most technologies. Conclusions: Current literature, the results from this study and technology trends within society highlight both Mhealth and E-forms as the 2 most promising virtual healthcare technologies for use in the pre-operative pathway for orthopaedics. Areas such as pre-operative assessment, triaging and prehabilitation are prime candidates for virtual intervention. Future research should also consider including patient opinions on any proposed interventions, as well as taking into account barriers to implementation. Keywords: Healthcare professionals, E-health, Mobile health, Virtual reality, Remote monitoring, Telemedicine, Telehealth, Pre-operative pathway, Elective orthopaedic surgery, Qualitative
* Correspondence: [email protected] 1 Imperial College London, Faculty of Medicine, South Kensington, London SW7 2BU, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
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