To try and give elective orthopaedic surgery patients a better, more supported experience, NHS surgeons Tom Harte and Axel Sylvan have developed a new app that guides patients through every stage of their treatment journey and helps speed up surgical recovery time, as Sophia Ktori discovers
The myrecovery app isn’t just a collection of instructions, written guidelines and images – it’s more of a digital companion, Tom Harte explains, where the surgeon and supporting clinical team talk directly to the patient to provide information and advice relevant to their procedure. ‘Axel and I are both surgeons but we’ve also been on the sharp end of the surgical knife. Having undergone major surgery, we understand first-hand how hard it is to remember information that may have been given weeks before a procedure, how difficult it can be to manage your surgery recovery safely at home when you may be in pain, and how worrying it can be when you don’t know if a post-operative symptom is normal or not.’
myrecovery provides the patient with information and advice tailored to the orthopaedic operation they are undergoing, who is carrying out the surgery, and any methods or routines specific to the hospital. The app is partially interactive, and the information and videos that patients receive daily will depend on their answers to specific questions. ‘myrecovery includes footage of the surgeon explaining the procedure and recovery process,’ Harte says. ‘Clinicians then provide guidance and daily advice throughout the surgery recovery process, to help patients manage their symptoms and mobility issues, such as negotiating everyday activities when wearing an arm sling, or protecting a shoulder when lying in bed.’ In addition, myrecovery provides videos of the patient’s recommended physiotherapy exercises. ‘Physiotherapists love it because the exercise videos are far better at engaging patients than instruction sheets, which tend to get lost or thrown away.’ And they’re easier to follow.
Patients using the app feel more confident about managing their recovery, which can speed up their return to fitness, Harte stresses. ‘They’ll know what they might be able to do within a day, a week or a month of the procedure, and when they might be able to return to different types of work, or walk the dog, for example. It’s not just about the clinical aspects of recovery, but about lifestyle too. They want to recover safely but without putting their lives completely on hold. That’s really important.’
In addition, setting up myrecovery isn’t overly time-consuming for clinicians and supporting staff, Hart adds. ‘We work with the surgeons to devise a module for a particular procedure, and this includes the videos, advice, guidelines and other information from the clinical team. The patient signs up as soon as they have decided to go ahead with the surgery, and their treatment journey progresses from that point.’
myrecovery is also about improving efficiency, very much following the current vogue for apps and devices that help patients to have a greater awareness of and control over their health. ‘The healthcare system is hugely inefficient,’ Harte says. ‘Studies indicate that getting surgical patients home as soon as it is clinically safe to do so can result in improved outcomes. Yet hospital stays are often days longer than they need to be because patients aren’t confident about going home, especially if they are in pain, and aren’t told in advance when they’re likely to be discharged. Those who are well-informed and feel supported are happier to go home sooner.’
Well-informed patients also make far fewer unnecessary phone calls to their consultant and physiotherapist. They’re less likely to make panic visits to emergency departments or clinics, and there are fewer readmissions due to reinjury or poor healing, Harte continues. ‘But it’s important to understand that the app isn’t designed to replace a nurse, doctor or physiotherapist, but to reduce unnecessary contact time. It helps to achieve that gold standard of care. Data already suggests that using myrecovery can reduce the number of post-operative phone calls to the clinical team by 40 per cent.’
The app currently comprises one standard module for each surgical procedure, but Harte, Sylvan and the 10-strong myrecovery team ultimately aim to tailor each module to specific cohorts of patients, such as those of different ages. ‘A 48-year-old undergoing a knee-replacement operation won’t necessarily have the same treatment journey as an 80-year-old,’ Harte explains. ‘We want to address the pain points for subsets of patients as they recover, and these pain points may include how easy it is to sit at a desk after four weeks, or how soon a patient might be able to negotiate public transport.’
The app is now free for patients in the private sector. There are also plans to roll it out in the US. Harte and Sylvan have both been awarded NHS clinical entrepreneur fellowship status for their development of myrecovery. The app isn’t yet available to NHS patients, but that may change soon, Harte hints. ‘We’re hoping that a number of NHS trusts will launch the app within the next couple of months.’
He stresses that while opportunities for apps to support patients through medical intervention and recovery is evident, it’s important that developers focus on what they’re good at. ‘It’s said that digital health is the fourth most trusted resource for healthcare information. We believe that if information, guidance and advice is to be completely reliable, it should come from the clinicians themselves and be directed to only those undergoing the relevant procedure. You can’t give the same advice to a patient undergoing an elective knee replacement and to someone having a hip replacement.’
Harte and Sylvan have taken a break from full-time clinical practice to concentrate on developing and rolling out myrecovery. The team will continue to expand the app to encompass different elective orthopaedic surgery procedures, but there are no plans to branch out into different specialties.
‘Estimates suggest that the US market for knee and hip replacements alone is worth some $65 billion a year, and is set to grow fourfold by 2030. That’s a big enough market for us. We’ll stick to our area of expertise, where we know that we can deliver the most clinically and lifestyle-relevant content for patients. There’s huge opportunity for growth just within the orthopaedics market, and for us to provide increasingly more detailed, patient-focused support and care for each type of surgery. Ultimately, the feedback from this type of interaction could help clinicians to devise even more effective recovery programmes for patients.’
While myrecovery may not be thought of as medtech in the traditional sense, this is more a case of semantics, Harte suggests. ‘The term “medical technology” surpassed hardware and equipment a couple of years ago. I believe that we’ll also move away from the phrase “digital health” in the next couple of years, as it just becomes part of everything that we do in healthcare. It’s already happened in other industries. We no longer refer to “digital banking”, or even “online banking” any more, for example, it’s just the new standard that we expect. The next stage will be an expansion in our use of Big Data and the continued development of capabilities in fields such as machine intelligence.’
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