How a Text Message and a GoPro Video Made It Easier to Walk With a New Knee

By Kulmeet Singh, Chief Executive Officer, Founder, Twistle
Published 07/12/2019
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Doctor writing a prescription on tablet


Barbara has painful osteoarthritis in her 71-year-old knees, and it’s time to replace the left one. On the day of surgery, her husband drives her to the sprawling complex that is the hospital. On reaching the hospital’s main intersection, the couple has a choice of several paths to different parking lots, and it is unclear which one provides the shortest walk. Barbara fumbles through her paperwork but takes a guess. She ends up with a long walk to the right building, and an even longer walk after taking the wrong elevator to the surgery suite. She feels like “a rat in a maze.”

Too often the first instinct of technologists is to help Barbara with a clever software solution, perhaps designing a Waze-like navigation app to help her find the best way into the healthcare facility. Indeed, technology innovations have led to breakthroughs in all areas from drug discovery to surgery, delivering better quality care.

But technology doesn’t always solve problems well, especially when its designers pay little heed to user experience. For example, electronic health records (EHRs) and patient portals have arguably impeded rather than improved physician-patient interactions. Technology certainly can improve patient experience if the real-world problems that patients and their clinicians face are taken into account. Sometimes that’s as simple as helping a patient find their way.

Barbara’s challenging experience with her healthcare system included:

  • Interrupted interactions with her physician – Most of the time her physician had his head buried in a computer, worried more about completing his documentation than caring for her
  • Using the patient portal – Activating her account was a chore, and even then, the information available was less useful and relevant than what she was able to get from Google.
  • Phone tag with her care team – In the 90 days before and after her surgery, she connected with her care team less than 1 out of every 4 tries.
  • Bewildering language – One of her documents mentioned “Replacement of Left Knee Joint, Femoral Surface with Autologous Tissue Substitute, Open Approach.” Huh?
  • Waiting, waiting, waiting – At every appointment with her care team, she was asked to wait and be patient.

In recent years, leading healthcare systems have responded by beginning to organize themselves around what matters to the patient. For instance, a breast cancer patient has to navigate several specialties to get better: oncology, radiology, radiation oncology, and surgery. As early as the 1970s, clinicians understood that a multi-specialty approach delivers better outcomes in breast cancer. But these specialties continued to be located in different parts of most health systems, and the handoff from one silo to the next was clumsy. Patients might find themselves traveling to an imaging center, then to an ambulatory surgery center and the oncology group, which could be a private practice in yet a different part of town. Organizing around specialties may be sensible from the clinician’s perspective, but for a patient, these organizational silos aren’t relevant to getting better. Leading health systems then started delivering a breast health experience that is more integrated for the patient, by providing multi-specialty centers where specialists come together for the patient. This approach has been extended to digestive health, cardiovascular health, and many other areas as well.

Adrienne Boissy MD, the Chief Experience Officer at the Cleveland Clinic, advocates for empathy as the linchpin for great patient experience, and her holistic perspective extends consideration not just to patients, but also to clinicians. “That attention to [caregivers’] experience and their own suffering is incredibly powerful as you’re trying to drive behavior change,” says Dr. Boissy.

Technology can play a positive role in improving the lives of patients and clinicians, delivering better healthcare outcomes, and perhaps most importantly, empowering patients and their caregivers as true partners in the delivery of care. Population growth in the US and around the globe is far outstripping the growth in healthcare providers. Combined with the explosion in healthcare knowledge, it’s simply impossible for healthcare providers to manage all patients effectively and with empathy without the assistance of technology. Furthermore, patients that want the best outcomes cannot depend solely on the healthcare system; they need to be involved in their own care, and technology can empower them in this regard.

In Barbara’s case, her care team started using a care automation platform. Rather than subject her to forty pages of instructions to prepare for and then recover from surgery, they configured a surgical pathway on the platform that will message her on her phone with the key information at the right time, in manageable chunks. And in a flash of brilliance, one of the nurses strapped a GoPro video camera to her head and recorded in real-time as she drove from that confusing hospital intersection to the best parking lot and walked to the correct surgical suite.

Now when Barbara comes back for her next knee replacement surgery, she will get a message a few hours before her appointment that includes that video clip. Today, we have opportunities to explore and exploit a whole range of technology solutions to improve communication between caregivers and patients to deliver better outcomes. Let’s find creative ways to take advantage of them.