Masimo announced the findings of a prospective study published in the Journal of Orthopaedics in which Dr. Michael DeRogatis and colleagues at St. Luke?s University Health Network (SLUHN) in Pennsylvania, joined by researchers at several additional institutions, 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.

The researchers found that patients who were remotely monitored after being discharged had significantly lower rates of hospital readmission and ED visits. 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.? 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.? 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. Masimo SafetyNet is not intended to be used for real-time monitoring.