Last week, our colleagues from Mount Sinai AppLab presented on the successful implementation of a Digital Navigation Program (DNP) to improve outcomes for Medicare bundle patients undergoing joint replacement surgery (TJR) at Mount Sinai Health System. The TJR DNP was well adopted by patients, caregivers and clinicians; demonstrated that that digital navigation technology can be used even among non-digital native patients; resulted in significant improvement in clinical outcomes; and yielded high patient satisfaction.

The Mount Sinai Hospital (MSH) participates in the mandatory CMS bundle for comprehensive joint replacement (CJR). MSH’s bundled payment strategy is to develop a standardized model of care, built around evidence-based best practices to achieve the triple aims of strengthening population health while controlling cost and improving the quality of care. Success in bundles and improvement in clinical outcomes therefore depends largely on patients’ pre-operative education and preparation. MSH launched a comprehensive digital navigation program to guide joint replacement patients and their caregivers through pre-surgical preparation and recovery.

The results presented throughout the poster session at CHC, highlighted various improvements in clinical outcomes among patients enrolled in the DNP including a reduction in length of stay (2.7 days vs 3 days), reduction in hospital readmissions (0.8% vs 1.9%) and increased ambulation on day of surgery (47.9% vs 33.3%). The results also showed high levels of engagement among patients as well as high patient satisfaction with the DNP.

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The Sinai AppLab is an internal digital medicine innovation group within Mount Sinai Hospital with the mission to serve as a model for healthcare systems, by leading through collaboration and innovation in development, use, training and evaluation of informatics to support medical research, improve patient outcomes and facilitate continuous quality improvement. The focus is not only in building innovative technology solutions utilizing human-centered methodology but in conducting rigorous evaluation as well to build evidence for our solutions.