Masimo’s RPM (remote patient monitoring) technology helped reduce hospital readmissions and ED visits for post-surgical total joint arthroplasty (TJA) patients.

RT’s Three Key Takeaways

  1. A study in the Journal of Orthopaedics found that total joint arthroplasty patients using Masimo SafetyNet had significantly lower readmission and ED visit rates.
  2. The study involved 100 patients, split into those with remote patient monitoring using Masimo SafetyNet and those without, comparing postoperative outcomes.
  3. RPM patients had only 4% ED visits and no readmissions, versus 12% ED visits and 100% readmissions in the control group, potentially saving $800,000 per 1,000 surgeries.

Discharged patients recovering from total joint arthroplasty (TJA) who were remotely monitored using Masimo SafetyNet had significantly lower rates of hospital readmission and ED visits, according to results of a prospective study reported by the company.

The study, published in the Journal of Orthopaedics, evaluated the impact of remote patient monitoring (RPM) using Masimo SafetyNet and a hospital’s virtual response center (VRC) on 30-day readmission rates for patients undergoing acute postoperative recovery after total joint arthroplasty (TJA).

Masimo SafetyNet, a remote patient management and telehealth platform, pairs with a variety of Masimo and third-party devices to seamlessly transmit home-based patient data to hospital clinicians.

Noting that while the trend toward performing TJA as outpatient surgery reduces hospital length of stay (LOS), the practice decreases “available time to monitor for postoperative complications,”1 the authors sought to investigate whether equipping patients with RPM could offer the best of both worlds: outpatient surgery with the ability to track vital signs and more easily stay in touch with patients while they recuperate at home. They enrolled 100 patients who were scheduled to undergo total knee or total hip surgery at SLUHN, divided into two groups: 50 who did not receive RPM after discharge (2021-2022), and 50 who did (2022-2023). Various characteristics (demographics such as age, gender, race, BMI, and marital status; hospital LOS; ASA score; and Charlson Comorbidity Index) were compared between the cohorts and there were no significant differences (p > 0.05), although hospital LOS was slightly shorter in the RPM group (29.4 hours vs. 30.4 hours).

Patients in the RPM cohort were discharged with a Masimo MightySat pulse oximeter and an Omron blood pressure monitor, provided by Masimo, which connected wirelessly to the Masimo SafetyNet app. For 48 hours after discharge, patients checked their vital signs four times daily. Data recorded by Masimo SafetyNet (including manually entered temperature data) were automatically uploaded to the hospital’s virtual response center for review by hospital clinicians, who reached out to patients as needed to address abnormalities or signs of physiological decline, provide guidance, and, if warranted, recommend returning to the facility for in-person care. Patients in the control group, who did not receive RPM, were discharged with routine TJA postoperative instructions.

The researchers found that in the RPM cohort, 10 patients (20%) recorded abnormal vital signs and 2 patients (4%) visited the ED; no patients were readmitted to the hospital. In the control cohort, 6 patients (12%) visited the ED and all visits resulted in hospital admission – significantly higher rates of ED visitation and hospital readmission (p = 0.03).  The causes for the readmissions included two hip dislocations, cellulitis (soft tissue infection), and uncontrolled pain. The authors noted that other than the dislocations, these readmissions “could have been prevented with remote home monitoring.”1 They conservatively estimated a readmission cost of $7,000 per patient.

Although they did not conduct a formal cost analysis of the RPM program, the authors estimated that, after taking into account the potential cost avoidance of fewer hospital readmissions, for every 1,000 TJA surgeries performed, the RPM program “could potentially result in a hospital savings of $800,000.”1

The researchers also surveyed patients in the RPM cohort about their experience and found that most held a favorable view of the program: 79% strongly or somewhat agreed that RPM helped in their care at home, 79% strongly or somewhat agreed that it made them feel safer, and 79% strongly or somewhat agreed they would recommend RPM to someone they know. 

The authors concluded, “As total joint replacements are increasingly being performed in the outpatient setting, postoperative patient monitoring from home is a feasible way to help mitigate readmissions in the postoperative period. The utility of a virtual response center would be to identify, in real time, certain patient metrics that could indicate potential complications and ultimately allow for more timely intervention that may prevent morbidity and readmissions. Efforts to minimize costs should not be implemented at the expense of patients’ health outcomes with a goal to find an appropriate balance between both agendas.”1

. They concluded, “Remote home monitoring with a virtual response team after outpatient TJA is a feasible way to mitigate readmissions in the acute postoperative period and increase patient satisfaction.”1

RPVi has not received FDA 510(k) clearance and are not available for sale in the United States.

References

  1. DeRogatis MJ, Pellegrino AN, Wang N, Higgins M, Dubin J, Issack P, Sokunbi G, Brogle P, Konopitski A. Enhancing recovery and reducing readmissions: The impact of remote monitoring on acute postoperative care in outpatient total joint arthroplasty. J Ortho. 26 June 2024. 58(2024). DOI: 10.1016/j.jor.2024.60.028.
  2. Published clinical studies on pulse oximetry and the benefits of Masimo SET® can be found on our website at www.masimo.com. Comparative studies include independent and objective studies which are comprised of abstracts presented at scientific meetings and peer-reviewed journal articles.
  3. Castillo A et al. Prevention of Retinopathy of Prematurity in Preterm Infants through Changes in Clinical Practice and SpO2 Technology. Acta Paediatr. 2011 Feb;100(2):188-92.
  4. de-Wahl Granelli A et al. Impact of pulse oximetry screening on the detection of duct dependent congenital heart disease: a Swedish prospective screening study in 39,821 newborns. BMJ. 2009; Jan 8;338.
  5. Taenzer A et al. Impact of pulse oximetry surveillance on rescue events and intensive care unit transfers: a before-and-after concurrence study. Anesthesiology. 2010:112(2):282-287.
  6. Taenzer A et al. Postoperative Monitoring – The Dartmouth Experience. Anesthesia Patient Safety Foundation Newsletter. Spring-Summer 2012.
  7. McGrath S et al. Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation. The Joint Commission Journal on Quality and Patient Safety. 2016 Jul;42(7):293-302.
  8. McGrath S et al. Inpatient Respiratory Arrest Associated With Sedative and Analgesic Medications: Impact of Continuous Monitoring on Patient Mortality and Severe Morbidity. J Patient Saf. 2020 14 Mar. DOI: 10.1097/PTS.0000000000000696.
  9. Estimate: Masimo data on file.
  10. https://www.newsweek.com/rankings/worlds-best-hospitals-2024/united-states 

masimo rpm joint replacement