March 1st – 8th 2025, by Bill Hartman
We’ve been working with NGO Faith In Practice to use our award winning medtech platform to develop a bespoke patient record service supporting the patient pathway from initial presenting in clinic right through to surgery and rehab. This new service called ‘Insight’ revolutionises remote clinic levels where groups of healthcare providers may see over 1,000 patients per week. Recently I attended a surgical trip to Antigua Guatemala to assist and see first-hand their screening and scheduling processes using the PRO-MAPP platform.
Most patients we see do not need extended care, however a subset may be recommended for surgical evaluation. Of those evaluations, some are suitable for orthopedic joint replacement or major orthopedic reconstructive surgery. The vision of Insight is to provide records of the remote clinics and organize patient screening for surgical evaluation, the portability of x-ray images, details of surgical intervention, post-surgical follow-ups and patient flagging if further surgery screening is necessary.
During the week I wanted to determine how the current Insight system works to capture operative details, as well as how the technology can further be utilized to create efficient, organized, and prioritized surgical plans. I worked alongside the Hope In Motion team – over 50 people including surgeons, anesthesiologists, nurses, scrub techs, physical therapists, implant and instrument representatives, and even a specialist to oversee central processing, cleaning and sterilization.
Before Insight, patients arrived at the Obras (the hospital in Antigua) and were served on a first-come-first-served basis. Surgical schedules were filled, but perhaps not with the highest priority patients first. In one instance I witnessed a young rheumatoid arthritis patient who had fused hip joints and could barely walk, but by the time the team evaluated her condition, the surgery schedule was full. Had she been identified as a high priority patient in a remote screening process prior to the trip, her care could have begun that week. As it turned out, she must wait until the next surgical team arrives in a month.
PRO-MAPP and Insight also serve to follow patients and alert the following teams to further needs. I witnessed the right knee replacement for a male patient with severely varus legs, what we may refer to as bow-legged, while his left knee surgery was staged for a later trip. This staging is very important; the patient will do well with one surgery, yet much better when both knees are replaced, where the ability to track, communicate, and plan between surgical teams can facilitate this level of bilateral staged care.
The effect these surgical trips have on needy patients is profound to say the least. It was not uncommon for patients to travel several hours – and some up to 17 hours– hoping to see a doctor without truly knowing so until they are seen on Sunday. As the team arrived for triage on day one and walked past the queue of patients, the hope in their eyes was undeniable. Consequently, their level of gratitude following surgery is nearly impossible to describe. The patients interacted with the team, literally saying “God Bless You” as if a true miracle was bestowed upon them. We were all incredibly impressed with the bravery and tenacity shown by these patients, and their willingness to listen to post-op instructions and work with physical therapy.
The Hope In Motion and Faith In Practice collaboration had created an environment where 92 patients were operated on in 4 days, performing 55 total knee replacements, 16 total hip replacements, and 21 foot and ankle procedures. It was only later that I learned everyone at Hope in Motion had been asked to participate. In other words, the team is not voluntary, but by invitation only. This diligence creates a vastly experienced collective working towards the same goal and providing as much medical care as possible, all in a very short window of time in unfamiliar working conditions.
Not only was it humbling to see Insight becoming an integral tool to create more efficiency, organization, and planning, but in the hands of these excellent volunteers and organisations, it’s helping to provide the best patient care ever developed for underserved nations.
With further surgical trips planned, all of us are anticipating even greater strides in remote orthopedic care, and we’ll be sure to keep you posted.
