Health-GIS Platform for Hip Replacement Rehabilitation Coordination

Tulip Medicine

Status: Completed

Conditions: Hip Arthroplasty, Total; Rehabilitation; Hip Arthroplasty Replacement; Hip Osteoarthritis

Treatments: Other: Standard Rehabilitation Referral; Device: Health-GIS Rehabilitation Coordination Platform

Study type: Interventional

Funder types: Other

Identifiers

NCT07201116

NROC 4

Details and patient eligibility

About

This study tests whether a mobile phone app with mapping technology can help patients find rehabilitation services faster after hip replacement surgery. After having their hip replaced, patients typically need several months of physical therapy to recover fully. However, many patients face long waiting times or don't know where to find rehabilitation services near them.

In this study, half of the patients will use a new mobile app that shows rehabilitation centers on a map, displays available appointment times, and allows patients to compare services and costs. The other half will receive standard care, where they must contact their family doctor to help find rehabilitation services.

The study will measure how quickly patients start rehabilitation after leaving the hospital, how well their hip functions after treatment, their quality of life, and pain levels. The investigators will also look at whether the app is easy to use.

Full description

Total hip arthroplasty (hip replacement) is one of the most successful surgical procedures in modern orthopedics, with over 528 million people worldwide affected by osteoarthritis requiring joint replacement. The demand is projected to increase dramatically: 71% growth in the US by 2030 (635,000 procedures), 198% growth in Australia by 2046 (94,086 procedures), and 99-147% growth in Japan by 2030 depending on demographic groups.

Success of hip replacement surgery largely depends on timely access to rehabilitation services, particularly during the early recovery period (first 3-6 months post-surgery). Current medical rehabilitation principles emphasize early initiation, continuity, and seamless care coordination to optimize clinical outcomes. However, healthcare systems worldwide face significant challenges in organizing effective rehabilitation services.

The primary objective is to evaluate the effectiveness of implementing a GIS-integrated rehabilitation coordination platform for organizing early-stage rehabilitation after total hip arthroplasty. The investigators hypothesize that using a specialized mobile application with integrated GIS components will eliminate information gaps, ensure equitable patient flow distribution among medical organizations, reduce time from surgical discharge to second-stage rehabilitation initiation, and consequently improve functional treatment outcomes while enhancing healthcare system resource utilization efficiency.

After discharge from surgical hospitals, patients often encounter an information vacuum regarding available rehabilitation services. Primary care physicians typically have limited knowledge of regional rehabilitation centers, severely restricting patient routing options. This leads to systematic violations of key rehabilitation principles - early initiation and continuity of care - negatively impacting surgical outcomes.

Kazakhstan's healthcare system exemplifies these challenges, with critical imbalances between rehabilitation service demand and supply. Leading national centers performing thousands of hip replacements annually can provide rehabilitation to only a small fraction of patients, creating waiting lists extending several months. This disproportion generates systematic risks and healthcare delivery violations, with over 5.9 million healthcare delivery defects identified in 2024, including inappropriate service volume increases, unjustified medical care provision, and deviations from clinical protocols.

Healthcare digitalization offers innovative solutions to these systemic problems. Geographic Information Systems (GIS) have been successfully applied in various medical fields for analyzing spatial distribution of medical resources, optimizing patient routing, and improving service accessibility. A rehabilitation coordination platform with integrated GIS components could fundamentally transform rehabilitation service organization by providing transparency regarding available services, real facility capacity, and care accessibility.

Enrollment: 142 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age ≥18 years
• Completed primary total hip arthroplasty within the past 6 months
• Ability to understand study procedures and provide signed informed consent
• Fluency in Russian or Kazakh language
• Access to smartphone or tablet device with internet connectivity

Exclusion criteria

• Severe cognitive impairment
• Participation in another clinical trial that might interfere with study outcomes
• Intraoperative or postoperative complications requiring extended hospitalization after total hip arthroplasty
• Medical contraindications to rehabilitation
• Planned total hip arthroplasty within 12 months
• Severe visual impairments preventing mobile application usage
• Patients who declined to participate after being informed about the study protocol

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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142 participants in 2 patient groups

GIS-Guided Rehabilitation App

Experimental group

Description:

Patients receive access to a specialized mobile application with integrated Geographic Information System (GIS) components for rehabilitation service coordination after total hip arthroplasty.

Treatment:

Device: Health-GIS Rehabilitation Coordination Platform

Standard Primary Care Referral

Active Comparator group

Description:

Patients receive standard rehabilitation referral process through primary care physicians after total hip arthroplasty

Treatment:

Other: Standard Rehabilitation Referral