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Case Study: Patient Messaging Linked to Outcomes

Posted in The Top Line | Nov 2014 | Comments (0)

Tags: medical outcomes data collectionoutcomes


Evidence suggests that proactively engaging patients in their treatment can contribute to reduced costs and improved care. Patients are more confident and compliant when they are well-informed and supported throughout their care path—before, during and after a procedure.1

In 2013, when hospital leaders at Parkview Medical Center in Pueblo, Colorado, sought to have their Joint Center certified by the Joint Commission, they recognized that improving patient engagement was an important part of achieving that certification. Thus, they chose a pilot electronic communication program to enhance their knee and hip replacement patients’ experiences.

While they had previously employed print materials, videos and a “Caring for You Guide” binder to support patients, they realized that in order to support CMS’ Meaningful Use requirements to “engage patients electronically,” they needed to take action before surgery, during the hospital stay and throughout the recovery period to maximize success.

For this pilot, Parkview’s Joint Center used an email/video messaging series created from a collaborative effort between a proven video solution and a mobile-optimized email messaging program. This series connected the hospital and its patients as soon as a surgery date was set and continued through six months of rehab. Fifteen targeted messages presented the right information, instructions and videos at the right time—only what was relevant and needed at a specific time point. (See sample email and video.)

The series’ evidence-based content could be customized and updated at will by the Joint Center’s clinical staff, who could view analytics about usage as well as send additional alerts, reminders and support using the same database of patients. Parkview used this to add patient resources and make iterative enhancements to messages based upon patient feedback and usage.


Participation: Beginning in January 2014, all of Parkview’s patients scheduled for hip or knee replacement surgery were invited to participate in this pilot education and engagement program with the option to receive the Joint Center’s new email/video communication series before, during and after their hospital stay for six months post-discharge.

The pilot study group comprised 241 patients: 184 knee replacements and 57 hip replacements. The group was divided into two subsets:

1. those receiving the email/video series (88 knee patients and 29 hip patients)
2. those not receiving the email/video series (96 knee patients and 28 hip patients)

What Patients Received

All knee and hip replacement patients received a printed binder about their upcoming hospital stay (the aforementioned “Caring for You Guide”) and an invitation to attend an orientation class.

Beyond this, the Joint Center clinical staff subscribed patients to receive weekly emails with instructional videos starting as soon as four weeks pre-surgery and continuing through six months post-op. These patients also received an online survey two weeks post-op. The email/video series also provided patients with a secure means to ask questions and connect directly with a clinical staffer at the hospital.


Profile of Patients

Age & Gender

• The average age of hip replacement patients who received the email/video series was 68 years old; the non-email/video series group averaged 69 years old.

• The average age of knee replacement patients in the email/video series group was 65 versus 70 years old in the non-email/video series group.

• For both hip and knee patients, there were more women than men in the group that received the email/video messages (75% women in the hip group, 65% women in the knee group).

Pre-Op Class and Digital Series 

• Parkview’s goal was to engage 75% of its knee and hip replacement patients. With classes and the email/video series, they exceeded this goal and provided education and support to patients before, during and after surgery.


• 75% of patients participating in the email/video messaging program had Medicare/Medicaid insurance.

• 87% of those not in the email/video group had Medicare/Medicaid insurance.

Zip Code

• The majority of Parkview patients in this sample resided in urban locations (61% of the knee patients and 50% of the hip patients in the email/video series group). It should be noted that Parkview’s catchment area is 26,000 square miles, with a population of 242,000.

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