For many organizations in the healthcare industry, achieving the highest quality of care while lowering the overall cost of care is a major goal. As a leader in outpatient joint replacement surgery, physician-led SwiftPath Program LLC is uniquely positioned to help surgeons and facilities accomplish that goal. While the national average for patients to return to normal activity after knee joint replacement is about 10 weeks; for patients of some surgeons using the
SwiftPath Method, the average is about 4.4 weeks. The company’s approach to patient engagement and shared decision making are the key elements driving SwiftPath’s success, according to Co-founders Craig McAllister, MD and Ira Kirschenbaum, MD.
SwiftPath is a protocol-driven, cloud-based care redesign company, focused on improving the entire episode of care around hip and knee joint replacement by providing leading edge protocols and technology platforms used by surgeons and their patients in an early hospital discharge or outpatient setting.
When it comes to joint replacement surgery, whether the procedure is performed at the hospital or at an ambulatory surgery center as an outpatient procedure, patient engagement is as important to the outcomes and success of surgery as the methodology, capability and experience of the surgeon. SwiftPath’s mission is to develop the highest quality processes for orthopedic episodes of care, and the team considers how to enhance patient engagement at every step in the process.
Since the healthcare system is complex, very expensive and foreign to most patients, SwiftPath has redesigned the episode of care to incorporate extensive education of patients and their caregivers prior to surgery. This enables patients to actively and confidently participate in decision making and empowers them to proactively co-manage their care with the medical team before and after surgery.
The software and tools developed by SwiftPath for patient engagement are seamlessly integrated with the surgeon’s protocols. SwiftPath’s most powerful patient engagement tools include its educational Joint Camp; a Patient Guide that includes surgeon-customized content covering the entire episode of care from initial assessment to completion of recovery; and SwiftPath’s online platform for patients and their doctors to communicate regarding tasks and outcomes during the episode of care. Dr. McAllister says, “These tools and materials provide specific guidance and give most patients the confidence to choose outpatient or early release hospital stays, with recovery in the comfort of their homes.”
Journey: An Example of Care Redesign in Action
Started in the year 1991, SwiftPath began by envisioning and developing state-of-the art minimally invasive surgical techniques for joint replacement. The goals then were to develop safe protocols that would reduce hospital stays by incorporating smaller incisions and blood sparing techniques, and to decrease the reliance on opioids for pain management.
In 2002, SwiftPath published its results using minimally invasive surgical techniques. Lengths of stay were reduced from six or seven days in the hospital (using traditional surgical techniques) to three or four days (using minimally invasive surgical techniques). Patients were using fewer opiates and the return to normal activity was quicker. Over time, continual improvements in protocols were made and the length of hospital stays continued to decrease.
Dr. McAllister says, “By 2006, we were literally sitting in the lab, looking at each other and saying this could potentially be outpatient surgery, but we would need to engage the patient in a totally different way. We recognized that a move to the outpatient space would require a cloudbased platform that would engage patients from the very beginning and over the entire episode of care.”
The two co-founders would also need to develop new protocols for surgeons to use in an outpatient setting. They spent ten years working with surgeons around the country to develop and fine-tune the SwiftPath Method. Today SwiftPath is highly respected for its leadership in the development of surgical protocols and patient engagement programs that support outpatient joint replacement surgery.
Two Accomplished Surgeons, One Goal
Dr. McAllister and Dr. Kirschenbaum are close friends and have known each other since they trained together as residents. For both, the work they do is all about the patient: patient safety, the patient experience, and patient outcomes. Both are successful surgeons and visionaries and their partnership has been a pivotal factor in SwiftPath’s success.
Dr. McAllister has a clinical and academic background that includes a strong focus on surgeon education, patient education, minimally invasive surgical techniques, computer navigation, and outpatient joint replacement. He tends to drive the development of clinical protocols. Dr. Kirschenbaum has a notable career in information technology and is a leading authority on cloud databases, clinical apps, and online communication. He focuses on the software and digital platforms that support SwiftPath’s surgeons and the interaction with their patients.
SwiftPath serves two client groups: providers and patients. Key benefits for SwiftPath surgeons include access to and training in the SwiftPath Method, engagement with other like-minded surgeons, the opportunity to participate in RoundTables to review and determine best practices, use of SwiftPath’s patient engagement platforms, cloud-based reporting of patient outcomes and publication of surgeon-authored Patient Guides.
For patients, SwiftPath’s reputation is built on active patient engagement, reduced narcotic use and a faster return to full activity.
Minimally invasive surgical techniques lead to faster healing. Multimodal pain management means moving away from opiates as the primary or only source of pain management and the introduction of alternatives to deal with discomfort after surgery. SwiftPath’s home care monitoring program actually engages patients on a real-time basis.
Patients can directly communicate through text messages and emails to the care team, be it the surgeon, a physician’s assistant or nurse navigators. This enables the care team to get real-time messaging from the patients and deal with problems at the moment they are occurring.
“I think that patient engagement has increased the efficiencies considerably,” says Dr. McAllister. “Patients report on a number of items including daily pain for the first 4 days, and the number and dosage of opiates taken daily. We can avoid readmissions and other problems, but also get analytics. We get the kind of analytics that can change behavior.”
Redefining Patient Engagement
Patient engagement, as SwiftPath executes it, is measurable. It is consistent; it provides analytics; and it is done on a platform where the reported information can be operationalized in a way that makes the episode of care more predictable and more consistent, resulting in better outcomes and better overall patient experience. “The level of patient engagement that SwiftPath brings to the episode of care for hip and knee replacement is unparalleled in traditional hospital-based joint replacement surgery,” says Dr. McAllister.
Patient engagement is a major focus for SwiftPath and the company will continue to enhance its patient engagement programs and tools. With advances in cloud-computing technology, the company looks forward to opening platforms for electronic medical records and multichannel access to cloud-based tools for its patients. According to Dr. McAllister, “That’s the road to a truly digitally enabled healthcare system.”