{
  "abstract": "Background\n\nAutomated text messaging systems (ATMS) are increasingly used to support perioperative care in total joint arthroplasty. However, their effect on patient-initiated communication patterns and clinical workflow remains incompletely defined. This study evaluated changes in perioperative phone call and portal message volume following implementation of an ATMS in a high-volume arthroplasty practice.Methods\n\nPatient-initiated phone calls and secure portal messages were prospectively tracked during the 2-week preoperative and postoperative periods for patients undergoing primary total joint arthroplasty before and after ATMS implementation. Two sequential cohorts were compared: preimplementation (n = 145) and postimplementation (n = 101). Communications were categorized by modality, timing, and topic. Zero-inflated negative binomial regression was used to assess differences in communication volume, adjusting for age.Results\n\nPatient-initiated phone calls decreased from 2.23 ± 2.87 per patient before implementation to 1.24 ± 1.83 after implementation. In age-adjusted models, the postimplementation cohort had a 44% lower phone-call rate (incidence rate ratio 0.56, 95% confidence interval 0.39-0.80; P = .001). Portal message volume and total communications did not differ significantly between cohorts. These findings demonstrate an association between ATMS implementation and fewer phone calls, but do not establish a compensatory increase in portal messaging or a reduction in overall communication volume.Conclusions\n\nImplementation of an ATMS was associated with fewer perioperative patient-initiated phone calls, while portal message volume and total communication volume were not significantly different. Given the sequential pre-post design, these findings should be interpreted as an association rather than a direct causal effect. Further controlled studies are needed to evaluate effects on staff workload, efficiency, cost, and patient experience.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Washington University in St. Louis, MO, USA."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Madeline A Sauer"
    },
    {
      "affs": [
        0
      ],
      "name": "Ling Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Oliver Forst"
    },
    {
      "affs": [
        0
      ],
      "name": "Robert L Barrack"
    },
    {
      "affs": [
        0
      ],
      "name": "Andrew M Schneider"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/98rnew0qq262p.bib",
  "cited_by": 0,
  "doi": "10.1016/j.artd.2026.102184",
  "fulltext_url": "https://europepmc.org/articles/PMC13694777",
  "id": "98rnew0qq262p",
  "issns": [
    "2352-3441"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927116",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3600|Mobile Health and mHealth Applications"
    ]
  ],
  "openalex": "W7222192612",
  "pdf_url": "https://europepmc.org/articles/PMC13694777?pdf=render",
  "pmcid": "PMC13694777",
  "pmid": "42927116",
  "published": "2026-10-16",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/98rnew0qq262p.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927116",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927116"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty.",
  "title_text": "Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/98rnew0qq262p",
  "venue": "Arthroplasty today",
  "versions": []
}