Digital transformation through collaboration: integrating a web-based total knee replacement intervention into a self-management app

Abstract

Background: Total knee replacement (TKR) is a common orthopaedic operation. Yet support for patients undergoing TKR is limited. Our previous research developed a web-based pre-operative education and prehabilitation intervention, the ‘Virtual Knee School’ (VKS), for patients undergoing TKR (1). To provide a sustainable pathway for implementing the VKS in practice and a platform for future research, we have partnered with ‘getUBetter’ – a company providing a self-management app to over a third of England’s Integrated Care Systems (ICSs) (2). Aim: To collaboratively integrate the VKS into the getUBetter app. Methods: Our multi-stage collaborative process involved setting up a licence agreement, sharing the VKS intellectual property, developing demo modules, and refining the demo modules using feedback from our project team and seven Public Contributors. We transparently documented adaptations to the VKS using the Framework for Reporting Adaptations and Modifications-Enhanced (3) and developed a logic model. Results: We collaboratively developed two new getUBetter app modules – ‘I’m Waiting for a Total Knee Replacement’ and ‘I’ve Had a Total Knee Replacement’. Team member and Public Contributor feedback led to valuable changes to the modules’ content. Adaptations to the VKS included restructuring the content, adapting the language, removing certain content, adding new content, and substituting VKS features with similar getUBetter app features. Our logic model visually represents the anticipated causal mechanisms of the getUBetter app and its intended outcomes, including improving patients’ pain, function and quality of life. Conclusion: Our team from the University of Leeds and getUBetter worked with Public Contributors to develop two new TKR modules on the getUBetter app. To maximise the modules’ impact and evidence base, we are commencing a feasibility study of the modules in Leeds and have implemented them throughout the South West London ICS. Our project demonstrates the value of collaboration for achieving the NHS’s priority of digital transformation.