Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty.
- 1Department of Orthopaedic Surgery, Washington University in St. Louis, MO, USA.
Abstract
Background
Automated 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
Patient-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
Patient-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
Implementation 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.
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BibTeX
@article{sauer2026impact,
title = {{Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty.}},
author = {Madeline A Sauer and Ling Chen and Oliver Forst and Robert L Barrack and Andrew M Schneider},
journal = {Arthroplasty today},
year = {2026},
month = oct,
doi = {10.1016/j.artd.2026.102184},
url = {https://europepmc.org/article/MED/42927116},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty.
AU - Madeline A Sauer
AU - Ling Chen
AU - Oliver Forst
AU - Robert L Barrack
AU - Andrew M Schneider
PY - 2026
DA - 2026/10/16
JO - Arthroplasty today
DO - 10.1016/j.artd.2026.102184
UR - https://europepmc.org/article/MED/42927116
AB - Background Automated 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 Patient-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 Patient-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 Implementation 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.
SN - 2352-3441
ER -