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Impact of Automated Perioperative Text Messaging on Patient-Initiated Communication After Total Joint Arthroplasty

Year: 2026
Type: article
Abstract: Background: Automated text messaging systems (ATMS) are increasingly used to support perioperative care in total joint arthroplasty. However, their effect on patient-initiated communication patterns and clinical workflow remains incompletely defined. This study evaluated changes in perioperative phone call and portal message volume following implementation of an ATMS in a high-volume arthroplasty practice. Methods: Patient-initiated phone calls and secure portal messages were prospectively tracked during the 2-week preoperative and postoperative periods for patients undergoing primary total joint arthroplasty before and after ATMS implementation. Two sequential cohorts were compared: preimplementation (n = 145) and postimplementation (n = 101). Communications were categorized by modality, timing, and topic. Zero-inflated negative binomial regression was used to assess differences in communication volume, adjusting for age. Results: = .001). Portal message volume and total communications did not differ significantly between cohorts. These findings demonstrate an association between ATMS implementation and fewer phone calls, but do not establish a compensatory increase in portal messaging or a reduction in overall communication volume. Conclusions: Implementation of an ATMS was associated with fewer perioperative patient-initiated phone calls, while portal message volume and total communication volume were not significantly different. Given the sequential pre-post design, these findings should be interpreted as an association rather than a direct causal effect. Further controlled studies are needed to evaluate effects on staff workload, efficiency, cost, and patient experience.
DOI: 10.1016/j.artd.2026.102184
Language: English
Open Access status: gold
Estimated APC paid: $2,500
OpenAlex ID: W7222192612
FWCI:
Cites: 11
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Related to: 10