Hospital for Special Surgery Study Shows AI Tool Effectively Prepares Patients for Joint Replacement Surgery

Preparing for orthopedic surgeries such as hip or knee replacement can be stressful for patients, who often have many questions and concerns about what to expect. Hospital for Special Surgery(HSS) presented new findings at the American Association of Hip and Knee Surgeonsannual meeting suggesting that artificial intelligence (AI) is a powerful educational tool that can help patients feel prepared and supported before and after surgery.

HSS researchers piloted and evaluated a custom-tailored AI (CTAI) platform that was trained on patient education content developed and approved by HSS surgeons. They found that patients were able to easily access and interact with the chat bot, which provided on-demand, personalized, accurate information about their surgery.

"Our study showed that most patients found the technology easy to use and helpful in making them feel ready and confident going into surgery," says Eytan M Debbi, MD, PhD, hip and knee replacement surgeon at HSS and senior author of the study.

HSS investigators partnered with Aidify to develop the CTAI agent to address patient questions related to total joint arthroplasty (TJA) procedures such as hip and knee replacement surgery. Orthopedic surgeons at HSS trained the chat bot with their specific surgical protocols so that patients could receive personalized content that reflects their expertise.

Patients undergoing orthopedic procedures frequently face confusion and anxiety before surgery and are often dissatisfied with printed educational materials that can be hard to understand and not tailored to their needs. However, patients in the study gave Aidify high marks for responses that were useful, understandable, and complete.

"This platform can provide round-the-clock access to reliable, doctor-specific guidance and reduce the risk of getting inaccurate or irrelevant information from other general-purpose tools like Google or Chat GPT," says Karlos Zepeda, DO, clinical research coordinator at HSS and lead author of the study.

The study included 40 patients scheduled to undergo TJA at HSS. Among the 32 patients who used the chat bot, about 85% said they understood the responses to their questions and 75% reported that it helped them feel well prepared for surgery. More than 80% of patients stated they would recommend the platform to others.

"I think patients get a lot of comfort knowing they have access to the chat bot because it gives them the sense that they can always be in contact with our office and get their questions answered whenever they need it," explains Dr. Debbi.

Patients in the study were emailed a link to the interactive platform trained on information about the surgery they were going to have. They could then type their questions into the chat bot and get responses instantly.

The CTAI tool addressed a wide range of questions that focused mostly on concerns leading up to surgery and on recovery. These included activity guidelines, medications, what to expect after surgery, dietary guidance, pain management, wound care, and potential complications. The bulk of patients' questions came in before surgery, while the number and frequency of questions diminished after surgery.

"Our findings show that CTAI improves patients' health literacy, which enables more understanding, confidence, and preparedness before surgery," says Dr. Zepeda. "This directly impacts patients' overall satisfaction and care experience."

The most unexpected finding, according to the authors, was the number of study participants who were able to access and navigate the platform. Most people who need TJA are over the age of 55, so there was a concern that older patients in the study might have some difficulty using AI technology.

"I was surprised that older patients were able to deal with the technology as easily as they did and be as satisfied as they were with it," observes Dr. Debbi, who adds that some patients preferred interacting with the chat bot over their surgeon. "Surgeons cannot be available to patients 24 hours a day, but AI can review things with multiple patients at a time, whenever and as many times as they want without physician burnout, so that's a huge benefit."

CTAI streamlines communication and reduces the burden of repetitive or nonurgent questions on busy clinical staff. "The power of AI can extend the surgeon and their team to more patients by efficiently addressing patient concerns in real time and ensuring that they consistently receive the right information exactly as their surgeon intended," explains Dr. Zepeda.

If the platform doesn't know the answer to a question or there is an emergency, it will prompt the patient to contact their doctor's office, call 911, and/or use the My Chart/Epic patient portal to send in their question to the appropriate provider, who would be notified of the issue and respond or escalate as needed.

"We are still in the research phase and very carefully monitor every question that comes in to make sure nothing slips through the cracks," notes Dr. Zepeda.

The study authors agree that their findings support continued refinement of CTAI as a tool to improve the delivery of patient education and care at HSS, but more research is needed to expand its use. For example, the technology does not currently have access to specific patient information.

"Only when we are confident in the technology and that patient information is secure will we enable AI to fully interact with patients' electronic medical record and integrate it as standard of care at HSS," says Dr. Debbi. "The potential of CTAI is unlimited. The sky's the limit and we're just scratching the surface right now."