Orthopedic Disorder
Conditions
Brief summary
This study aims to determine if inpatient enrollment into a patient communication app improves clinic follow-up of orthopedic trauma patients and improves survey completion rates after orthopedic trauma.
Detailed description
Follow-up in trauma is historically poor. As a result, outcomes from trauma are difficult to collect via surveys and are often significantly influenced by selection bias. Patient interaction apps like Patient Gateway are thought to facilitate greater participant involvement and adherence to treatment regimens. The investigators will explore if inpatient enrollment into Patient Gateway would improve clinic follow-up rates. Increasing follow-up rates could improve the quality of care delivered. In addition, self-administered survey questionnaires are an important data collection tool in clinical practice, public health research and epidemiology. However, survey completion rates are typically poor in orthopaedic trauma. With the evaluation of modern technology, electronic applications are being increasingly used in both hospital and personal settings. In outpatient clinics, questionnaires to measure outcomes and monitor quality of care are administered by staff members using hospital owned tablet devices. Recently, applications to complete these surveys on personal devices have been developed. In a recent Cochrane review on the comparison of self-administered survey questionnaire responses collected using mobile apps versus other methods it was concluded that there are no data available on response rates. The investigators will attempt to address this question. All Patient Gateway naïve patients aged 18 years or older able to consent for themselves and admitted to the hospital for an orthopedic condition with the need for outpatient follow-up will be invited to participate in this study. Exclusion criteria will be patients unable to consent for themselves, inability to communicate in English, and no possession of a smartphone.
Interventions
OTHERPatient Gateway
Patients will be enrolled in the Patient Gateway app.
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* admitted to the hospital for an orthopedic condition with the need for outpatient follow-up * able to consent for themselves
Exclusion criteria
* unable to consent for themselves * inability to communicate in English * no possession of a smartphone
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Return to Clinic | 3 months postoperative | The number of patients enrolled who return to clinic for a followup visit at 3 months postop. It will be a count and proportion of the occurrence of a patient returning to clinic for followup |
| Use of Any the Patient Gateway Portal at 3 Months | 3 months postoperative | The number of patients who used the patient gateway portal for any purpose at 3 months. This will be a count of participants. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Enrollment Group Patient Gateway: Patients will be enrolled in the Patient Gateway app with the assistance of a research coordinator as an inpatient. | 113 |
| Information Group Patients will be provided with information sheet only on how to enroll for Patient Gateway app. | 116 |
| Total | 229 |
Baseline characteristics
| Characteristic | Total | Information Group | Enrollment Group |
|---|---|---|---|
| Admission Subspecialty Joints | 75 Participants | 38 Participants | 37 Participants |
| Admission Subspecialty Oncology | 9 Participants | 5 Participants | 4 Participants |
| Admission Subspecialty Spine | 41 Participants | 23 Participants | 18 Participants |
| Admission Subspecialty Sports/Shoulder | 10 Participants | 5 Participants | 5 Participants |
| Admission Subspecialty Trauma | 94 Participants | 45 Participants | 49 Participants |
| Age, Continuous | 53.5 years STANDARD_DEVIATION 16.4 | 54.5 years STANDARD_DEVIATION 16.7 | 52.4 years STANDARD_DEVIATION 16 |
| Injury vs Acute Infection Elective | 136 Participants | 71 Participants | 65 Participants |
| Injury vs Acute Infection Injury or Acute Infection | 93 Participants | 45 Participants | 48 Participants |
| Median income by Zipcode | 82039 dollars STANDARD_DEVIATION 27091 | 80888 dollars STANDARD_DEVIATION 27853 | 83221 dollars STANDARD_DEVIATION 26358 |
| Race/Ethnicity, Customized Race Non-White race | 38 Participants | 17 Participants | 21 Participants |
| Race/Ethnicity, Customized Race White/Caucasian race | 191 Participants | 99 Participants | 92 Participants |
| Sex: Female, Male Female | 115 Participants | 55 Participants | 60 Participants |
| Sex: Female, Male Male | 114 Participants | 61 Participants | 53 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 113 | 0 / 116 |
| other Total, other adverse events | 0 / 113 | 0 / 116 |
| serious Total, serious adverse events | 0 / 113 | 0 / 116 |
Outcome results
Primary
Return to Clinic
The number of patients enrolled who return to clinic for a followup visit at 3 months postop. It will be a count and proportion of the occurrence of a patient returning to clinic for followup
Time frame: 3 months postoperative
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enrollment Group | Return to Clinic | 97 Participants |
| Information Group | Return to Clinic | 93 Participants |
p-value: 0.0574Chi-squared
p-value: 0.57Chi-squared
Primary
Use of Any the Patient Gateway Portal at 3 Months
The number of patients who used the patient gateway portal for any purpose at 3 months. This will be a count of participants.
Time frame: 3 months postoperative
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Enrollment Group | Use of Any the Patient Gateway Portal at 3 Months | 70 Participants |
| Information Group | Use of Any the Patient Gateway Portal at 3 Months | 19 Participants |