San Francisco-based PeerWell, Inc. has launched a “prehab” specifically for outpatient joint replacement centers. This announcements coincides with new reimbursement coverage from the Centers for Medicare and Medicaid Services [CMS] for knee replacement surgery in ambulatory surgery centers (ASCs).
New Tool for ASC-Based Knee Replacement Surgery
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According to the press release, “PeerWell’s outpatient pre-operative preparation [PreHab] program means that more patients can be indicated for outpatient surgery. With PeerWell’s guidance and support, the benefits of same-day surgery can be extended to patients who otherwise may not qualify,” said Nicholas Frisch, M.D., orthopedic surgeon and partner with Ascension in Bald Mountain Surgical Center in Lake Orion, Michigan.
“Our proprietary data collection is really what enables the full automation of our platform.
“PeerWell’s behavior modules have been served over 30,000 times and we’ve collected over 1,000,000 data points. This smart technology adapts to each patient and surgery type to deliver daily content that will be most beneficial to that patient,” said PeerWell CEO, Manish Shah. “The goal of our outpatient program is to offer the greatest support to patients so that they can benefit from a same-day discharge and at-home recovery.”
Graduates of PeerWell’s PreHab program for inpatient joint replacement surgery were discharged straight home 77% more frequently after surgery than the national average. PeerWell’s inpatient PreHab has cut down inpatient length of stay by 45%. Now, same-day joint replacement surgery candidates will be also be able to benefit from PeerWell’s proven programs.
Manish Shah told OTW, “Unhealthy behaviors are established over the course of years. Unwinding some of these behaviors—like quitting smoking or poor diet—requires a period of high motivation, and pre-surgery is that time for joint replacement candidates. We set expectations throughout our program that the patient is the owner of excellent outcomes, meaning that they’ll succeed if they put in the necessary effort.”
“We convert this sense of ownership and urgency into compliance with our multi-modal protocol covering a range of patient-driven determinants of success, including nutrition, anxiety management, exercise, smoking cessation, and home preparation.”
“Engaged, involved patients who have a sense of personal ownership over their health are the key to building a successful, safe outpatient surgery program. PeerWell’s autonomous, customized, daily program is a high quality, high efficiency way to optimize patients for surgery, manage their transition home and help them recovery safely and completely.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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