PROMs in Routine Arthroplasty Care: Better Outcomes for Patients and up to 100 Million Euros in Cost Savings annually

From the perspective of the Federal Joint Committee, the PROMoting Quality project has successfully implemented a new model of care with the help of digitally recorded PROMs for patients following inpatient hip or knee arthroplasty. The results demonstrate statistically significant improvements in numerous patient-relevant endpoints such as mobility, quality of life, work status and overall satisfaction with treatment outcomes as a result of post-operative PROM monitoring. In addition, the group that was monitored via the digital heartbeat platform showed an average cost reduction of €317 for a hip endoprosthesis and €324 for a knee endoprosthesis over one year compared to the control group.

According to the final report by consortium leader Technische Universität Berlin, PROM-based monitoring could lead to an annual increase of up to 4,400 Quality-Adjusted Life Years (QALYs) for hip patients and 3,908 QALYs for knee patients if implemented nationwide in  arthroplasty. The research team also estimates a savings potential of up to €100 million per year. Prof. Dr. Reinhard Busse, Head of the Department of Healthcare Management at TU Berlin, emphasizes: ‘In view of the large number of hospitals that operate on hip and knee joints, transparency about their results is very important for referring doctors and patients.’

As a technical partner and one of the project’s initiators, Heartbeat Medical has already advanced the approaches used in the PROMoting Quality study. For example, since 2022, PROvalue Endo, a digital post-operative monitoring system for arthroplasty, has been available to health insurance companies and hospitals through quality contracts. Beginning in 2025, medical teams will also be able to receive alerts about significant deviations in a patient’s recovery progress based on individualized PROM threshold values. These thresholds, supported by machine learning, dynamically adjust to each patient’s unique circumstances. ‘Since the launch of PROMoting Quality in 2018, we have gained valuable insights into what matters most to patients and healthcare teams,’ says Yannik Schreckenberger, founder and CEO of Heartbeat Medical. ‘The future of outcome-based care lies in patient-centered and individually steered pathways driven by value-based reimbursement.’

In its recommendation to implement the findings of PROMoting Quality into routine care, the Federal Joint Committee has forwarded the results to the Quality Assurance Subcommittee. The German Hospital Federation (DKG) has been requested to inform its members about these findings to support their integration into quality and care contracts.

Decision text of the Federal Joint Committee and evaluation of the consortium:

https://innovationsfonds.g-ba.de/beschluesse/promoting-quality-intersektorale-nutzung-von-patient-reported-outcome-measures-zur-steigerung-der-patientenrelevanten-ergebnisqualitaet.254

Publication on the study results:

Schöner, Lukas, et al. “Cost-effectiveness of a patient-reported outcome-based remote monitoring and alert intervention for early detection of critical recovery after joint replacement: A randomized controlled trial.” PLoS medicine 21.10 (2024): e1004459.