Aims To establish the feasibility of a closed-loop feedback system to remotely monitor and deliver personalised care to patients who have had a fractured Neck of Femur (NoF).

Methods Smartwatches were provided to NoF patients post repair and linked to the Cush Health digital web-app platform allowing visualisation of the data by the patient and their clinical team and access to personalised exercise/support plans. Monthly multidisciplinary meetings attended by the healthcare team reviewed smartwatch data and patient progress to progress rehabilitation. Objective outcomes (ie. smartwatch and quality of life data) was combined with subjective feedback from patients and the clinical team.

Results 3-month data showed positive engagement with technology and a progressive increase in step count data, reduction in average heart rate and reduced length of stay in a 62-89 years old population. Clinical lessons learnt include specific drivers and barriers for older populations; use of support networks can help engagement in those not experienced with technology; closed-loop system can empower patient autonomy and progress rehabilitation whilst an inpatient and help transition to community care. Independent analysis of the pathway showed cost and carbon emission saving benefits by facilitating a remote MDT and patients have responded positively by having the supported messaging via the platform.

Conclusion Our research has shown that a rapid deployment of a digital pathway is feasible and able to deliver better tailored rehabilitation to a wide number of patients. Further work needs to be done to establish best methods for engaging older populations and specifically those not confident in use of technology.

Technologies such as this have the potential to support patients from hospital to home, lending themselves to integration into the plans for the Integrated Care System