Association of Digital Health Software with Clinical Outcomes and Complications Following Total Knee and Hip Arthroplasty: A Retrospective Comparative Study
TL;DR
It is suggested that broad application of digital health tools, such as SMD, may enhance perioperative care and was independently associated with shorter LOS, while maintaining patient safety and avoiding an increase in complications.
Abstract
Digital health platforms have emerged as a novel and promising tool in healthcare services. This study evaluates the impact of a digital platform on clinical outcomes in patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) at a single academic institution between April 2023 and February 2025. We hypothesized that the use of a digital health platform would be associated with shorter length of stay (LOS) without increased 30-day emergency department (ED) utilization or readmissions. A total of 1285 patients were analyzed, with 859 patients enrolled in the Seamless MD digital health platform (SMD cohort) and 426 not enrolled (NON-SMD cohort). Primary clinical outcomes included LOS, ED visits, and readmission rates. Multivariable regression analyses were performed to adjust for age, sex, body mass index, procedure type, and surgical setting. After multivariable adjustment for baseline demographic and procedural variables, digital platform use was independently associated with shorter LOS (β = −0.92, 95% CI: confidence interval −1.30 to −0.54, p<0.0001), despite similar unadjusted LOS between cohorts (1.26 vs. 2.22, p=0.137). The 30-day ED visit rates were significantly reduced, with 136 (15.8%) in the SMD cohort and 89 (20.9%) in the NON-SMD cohort (p=0.025). However, on multivariable logistic regression, SMD use was not significantly associated with having ≥1 ED visit within 30 days (OR: odds ratio 0.77, 95% CI 0.55–1.09, p=0.14). 30-day readmission rates were similar between groups (3.6% vs. 4.5%, p=0.458). Integration of a digital health platform shows value in orthopedic care and was independently associated with shorter LOS, while maintaining patient safety and avoiding an increase in complications. This study suggests that broad application of digital health tools, such as SMD, may enhance perioperative care; however, further multi-center and prospective studies are needed to assess generalizability and causal impact. III, retrospective comparative study