Automated Hovering for Joint Replacement Surgery

The goal of this study is to test the approach of automated hovering to encourage patients to
be discharged to home safely after lower extremity joint replacement surgery (LEJR). The
investigators will target those patients undergoing hip or knee replacement surgery at a
large urban hospital system at two different sites. The investigators aim is to increase the
number of patients that are discharged to home, by providing patients with a physical
activity pedometer, daily pain score tracking through bi-directional text messaging,
milestone and nudge messaging for recovery, social influence, and connection to clinicians as
needed for 6 weeks after surgery. Eligible participants are age 18-85, with a Risk Assessment
and Prediction Tool (RAPT) score of 6-8 and are scheduled to undergo lower-extremity joint
replacement surgery. Participants will be randomized 1:1 to usual care (Arm 1) and
intervention (Arms 2a and 2b). After enrollment with the monitoring device, participants in
the intervention group will be randomized 1:1 to Arm 2a (remote monitoring) or Arm 2b (remote
monitoring + goal-setting and social support). Both intervention arms will receive the
intervention for 6 weeks post-surgery.

Inclusion Criteria:

- Eligibility Criteria: University of Pennsylvania Health System (UPHS) patients between
the ages of 18-85 with a Risk Assessment and Prediction Tool (RAPT) of 6-8 and
scheduled to undergo primary lower-extremity joint replacement surgery.

Exclusion Criteria:

- Patients will be excluded if they do not meet all of the inclusion criteria, or if
they have bilateral or revision surgery, dementia, end stage renal disease, cirrhosis,
metastatic cancer, non- English speaker, or other physical impairment (ex. amputation)