Telemedicine support shortens length of stay after fast-track hip replacement

Figures & data

Figure 1 The network used in the RRS study

Table 1. The telemedicine solution worked as a box for the TV set and covered the material listed

Interactive written information	With added speak and visualizations
Animation	A narrative story with elements of exposure. Described the background of primary hip arthritis, the anatomy of the hip, the surgical procedure, the importance of rehabilitation, risks, and limitations
Films of all recommended exercises	Simply described and with a supportive speak.
Films of how to use supplementary aids	Simply described and with a supportive speak.
Films of how to do daily tasks	Getting up and down from the floor, in and out of bed, in and out of a car, and so on.
Medicine	An interactive overview of prescribed medicine. What to take and when. Pictures and descriptions of each type of medication
Radiography	Pre- and postoperative radiographs
Video conference	Could be initiated by either the patient or the hospital. Camera was mobile and could be used for close-ups.

Table 2. Procedures in the 2 arms of the RCT

	Fast-track THR only	Telemedicine support
Day 0	Surgery	Surgery
Day 1	Training and rehabilitation	Discharge to home
Day 2	Discharge to home	Video conference
Day 3		Visit by physiotherapist
Day 6		Video conference
Day 21	Visit to outpatient clinic	Visit to outpatient clinic
Day 90	Visit to outpatient clinic	Visit to outpatient clinic

Figure 2. Flow of patients during the study period.

Table 3. Baseline data

	Fast-track THR only	Telemedicine support
Sex: F/M, n	17/19	17/19
Age^a, years	64 (45–84)	63 (43–80)
Distance^a, km	40 (1.8–57)	33 (0.4–57)
Implant type (n = 72)
Corail/BHR	29/7	31/5
Marital status (n = 66)
Alone/with partner	5/27	2/32
Job status (n = 66)
Working	11	19
On sick leave	0	2
Retired	20	13
Other	1	0
SCL-90R^a (n = 70)
GSI	47 (44–50)	47 (43–50)
PST	48 (44–51)	46 (43–49)
PSDI	45 (40–50)	51 (47–56)

a Median (range).

BHR: Birmingham Hip Resurfacing; GSI: global severity index.

PST: positive symptom total; PSDI: positive symptom distress index.

Table 4. Distribution of length of stay (LOS) for all patients

Group	1 day	2 days	3 days	4 days	5 days
Fast-track THR only (n = 36)	8	26	1	1	0
Telemedicine support (n = 36)	34	1	0	0	1

Figure 3. Outcomes over time.

Table 5. Unplanned contacts with the hospital. Values are mean (range)

	Fast-track THR only	Telemedicine support	p-value
No. of telephone calls from patient	1.5 (1.1–1.9)	0.92 (0.56–0.73)	0.04
No. of extra visits to hospital	0.31 (0.04–0.57)	0.17 (−0.01 to 0.34)	0.4
No. of re-admissions	0	0.03 (−0.03 to 0.08)	0.3