Not digitization for digitization's sake 

As a project manager in several projects on digital health, professor and physiotherapist Anne Therese Tveter is clear that digital solutions do not automatically lead to better treatment. For her, it is about further developing research that gives patients better conditions to make informed choices about their own health.

– It is not certain that digital solutions in themselves provide better treatment. The purpose of the studies we are conducting at Diakonhjemmet Hospital is to investigate whether we can follow up patients in new ways that are just as safe and effective but perhaps more health-economically favorable compared to current practice. Only then can digital solutions become a real part of clinical practice.

From a healthcare perspective, digital solutions can help relieve the burden on services, but this requires solid documentation.

From training results to professorship

For Tveter, her interest in research began early. Already as an active athlete, she systematized tests and competitions in her own graphs and tables to look at development and improvement.

Her curiosity about numbers and relationships was in place long before she formally became a researcher.

– I've probably always been interested in research, but perhaps a little unconsciously, she says.

However, it was only after completing my physiotherapy education that the path to becoming a researcher really took shape. An introductory course in research was the start. Then came a master's and doctoral degree at the University of Oslo.

Osteoarthritis and digital health – two paths that met

After her doctorate, Tveter combined an adjunct position as an associate professor at OsloMet with a postdoctoral position at Diakonhjemmet Hospital. The research environment at Diakonhjemmet Hospital was something she had long wanted to be a part of.

– Here I had the opportunity to delve into osteoarthritis research, especially hand osteoarthritis, and at the same time be a supervisor in my first project within digital health. Over time, these two tracks – osteoarthritis and digital follow-up – have become increasingly closely linked.

Her experience in project management, supervision and teaching laid the foundation for promotion to professor at OsloMet in 2023. In addition to being a project manager for several projects at Diakonhjemmet Hospital, she is also currently deputy head of REMEDY.

• Being able to help lead REMEDY is sometimes labor-intensive, but still a very educational and fun job.

OA-AID is based on experience – and research

One of the projects Tveter leads is the OA-AID project, which investigates digital follow-up in different parts of the course of a knee osteoarthritis patient. The first sub-project in OA-AID builds on the experiences from previous studies, including the development of the Happy Hands app for hand osteoarthritis.

– We saw how useful it was for patients to have access to knowledge and training programs in a digital format for patients with hand osteoarthritis. Then it was natural to ask: why not do the same for patients with knee osteoarthritis?

This began the development of an information and self-management app (Genus) that patients can access prior to their hospital consultation. In the long term, she also envisions similar solutions for other joints where osteoarthritis is common.

Better prepared before the meeting with the specialist health service

The core of the Genus app is an eight-week digital intervention where patients receive information about knee osteoarthritis, recommended treatment and exercises they can do at home. It also contains questionnaires, quizzes and tips and tricks that may be useful to the patient. The purpose is to make the patient better prepared before the first meeting with the therapist in the hospital.

–Healthcare personnel have access to the answers from the questionnaire before the consultation. This also allows the therapist to be better prepared when further treatment is to be considered.

The Genus app has been tested in a study to investigate usability. The experience from this was positive and provided the researchers with useful experience before starting a large randomized controlled trial with 225 participants.

Multiple sub-studies – one continuous patient course

Another substudy in OA-AID examines digital follow-up after knee replacement surgery. Here, traditional physical check-ups are compared with digital follow-up. The patients who participate will be followed up for one year after surgery. The patients who are selected for digital follow-up will answer monthly questionnaires for the first 3 months and will be called for a check-up in the hospital if the course is not as expected. The patients who are selected for the control group will be followed up with a check-up in the hospital 2 months after surgery.

– We want to find out if digital follow-up can be as safe and effective as current practice. If patients are functioning well after surgery, it is not necessary for them to come to the hospital. Then they can continue training at home instead. Check-ups at the hospital should be reserved for patients who really need it.

A total of 140 patients will be included in this study.

User input has been crucial

Currently, only patients who are referred to or operated on at Diakonhjemmet Hospital can participate. The ambition is to expand to other hospitals if the results are positive.

Users have provided valuable input into the development of content in the Genus app and in relation to what is important to ask about after the patient has had surgery. – The input has been crucial for how the projects have been designed.

Changing practices in the long term

In the long term, Tveter hopes that OA-AID can contribute to more knowledge-based and sustainable patient care.

– In five to ten years, I hope that we will have contributed to changing how osteoarthritis treatment is organized, with greater emphasis on coping, participation and more appropriate use of specialist health services.