Remote Culinary Coaching Shows Sustained Weight Loss Benefits in Adults with Overweight and Obesity
Key Takeaways:
- A fully remote culinary medicine programme combining cooking and health coaching led to sustained weight loss over 12 months
- Participants experienced significant fat mass reduction without loss of lean body mass
- Improvements in diet quality, calorie intake, and cooking confidence were observed alongside weight changes
Study overview
A recent randomised controlled trial has found that a fully remote culinary medicine intervention can support meaningful and sustained weight loss in people living with overweight and stage I obesity. The programme combined practical cooking education with health coaching, offering a patient-centred approach to improving dietary behaviours and long-term health outcomes.
Conducted across two hospitals between May 2019 and September 2022, the study examined the one-year impact of this combined intervention on weight, body composition, and dietary habits.
Methodology
Participant characteristics
The study included 50 adults with overweight or stage I obesity. Participants had a mean age of 47.5 years, and 70% were female. The average body mass index was 30.7, with a mean total fat mass of 40.37%. All participants reported cooking fewer than five meals at home per week at baseline.
Intervention design
All participants initially received two nutrition education sessions focused on the Mediterranean diet. Following this, they were randomly assigned to one of two groups:
- Intervention group: Participants took part in a structured culinary coaching programme consisting of 12 weekly one-to-one tele-sessions, each lasting 30 minutes. These sessions integrated culinary skills training with health coaching principles and provided access to culinary medicine resources.
- Control group: Participants were given access to the same culinary medicine resources but did not receive coaching sessions
Outcome measures
Researchers assessed a range of clinical and behavioural outcomes at baseline, and again at 3, 6, and 12 months within a hospital clinical research setting:
- Body weight and height were measured by a registered dietitian
- Body composition was analysed using dual-energy X-ray absorptiometry (DEXA)
- Dietary intake was calculated using 4-day food records reviewed by a registered dietitian
- Diet quality was evaluated using a 14-item Mediterranean diet assessment tool
- Culinary attitudes and self-efficacy were measured using a validated questionnaire
The primary outcome was change in body weight at 6 months, with secondary outcomes including dietary intake, body composition, and behavioural measures.
Weight loss outcomes
Participants in the culinary coaching group achieved significantly greater weight loss compared with the control group at all measured time points:
- 3 months: -3.23% vs -0.71% (between-group difference -2.52; P = .016)
- 6 months: -4.2% vs -1.22% (between-group difference -2.98; P = .027)
- 12 months: -4.02% vs a weight gain of 0.28% (between-group difference -4.30; P = .021)
These findings indicate that the intervention not only supported early weight loss but also helped sustain these changes over a full year.
Changes in body composition
At 6 months, participants receiving culinary coaching demonstrated favourable changes in body composition:
- Average fat mass decreased by 1.86% in the intervention group
- In contrast, the control group experienced a slight increase in fat mass of 0.11%
- The between-group difference was 1.96 (P = .039)
Importantly, these reductions in fat mass occurred without any significant changes in lean body mass, suggesting that weight loss was primarily driven by fat reduction rather than muscle loss.
Dietary improvements
The intervention also led to measurable improvements in diet quality and energy intake:
- At 3 months, Mediterranean diet scores increased by 2 points in the intervention group compared with 0.38 points in the control group (net difference 1.62; P = .020)
- At 6 months, daily calorie intake decreased by 452 calories in the intervention group compared with 62.4 calories in the control group (net difference 390 calories; P = .015)
These findings suggest that the programme successfully influenced both food choices and overall energy consumption.
Behavioural and skill-based outcomes
Participants who received culinary coaching reported significant improvements in their confidence and ability to prepare meals:
- Self-efficacy in cooking techniques and meal preparation improved significantly at 12 months in the intervention group compared with the control group (P = .040)
No serious adverse events were reported during the study, indicating that the intervention was safe and well tolerated.
Interpretation and clinical relevance
The study authors highlighted the broader significance of these findings, stating:
“This study is an important step in considering CM [culinary medicine] interventions as an effective patient-centered nutrition strategy for weight loss.”
This suggests that combining practical cooking skills with behavioural coaching may offer a scalable and effective approach to supporting people living with overweight and obesity, particularly in remote or resource-limited settings.
Limitations
The study has several limitations, many of which were influenced by the COVID pandemic:
- High dropout rates after the first visit may have introduced attrition bias
- Some follow-up visits were conducted remotely, requiring participants to self-measure body weight
- Remote assessments limited the ability to collect body composition and other clinical data at certain time points
- Pandemic-related restrictions may have affected participants’ ability to cook at home
These factors should be considered when interpreting the findings.
Funding and disclosures
The study was led by Rani Polak at Harvard Medical School and Spaulding Rehabilitation Hospital in Boston and was published in Obesity.
Funding was provided by the US-Israel Binational Science Foundation and the National Institutes of Health Clinical Center. One author reported receiving royalties from a home cooking book and an honorarium from Wellcoaches.
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Automated Weight Loss Programme Shows Promise for People Living with Cancer in Landmark Trial
Key Takeaways:
- A fully automated, web-based programme delivered clinically meaningful weight loss in people living with and beyond cancer, without any in-person support
- More than 43 percent of participants achieved at least 3 percent weight loss, with nearly one in three reaching 5 percent or more
- The intervention also improved a range of health outcomes, including diet quality, physical functioning, and cardiometabolic markers
A new model for post-cancer care
A large national randomised clinical trial has demonstrated that a fully automated, web-based weight loss intervention can deliver substantial health benefits for people living with and beyond cancer. The programme, developed by researchers at the University of Alabama at Birmingham, represents a significant shift in how post-cancer care may be delivered in the future.
Published in the Journal of the National Comprehensive Cancer Network, the study reported the highest level of weight loss ever achieved through a fully automated intervention in this population. The programme, known as the AMPLIFY Diet (AiM, PLan and act on LIFestYles), was designed to provide structured, evidence-based lifestyle support without requiring direct clinician involvement.
Addressing a major unmet need
A substantial proportion of people living with and beyond cancer are also living with overweight or obesity. In the United States, this figure is estimated to be around 70 percent. This places individuals at increased risk of cardiovascular disease, type 2 diabetes, functional decline, cancer recurrence, and the development of second primary cancers.
Despite this, access to specialist oncology dietitians remains limited. Traditional weight management programmes often rely on in-person consultations or regular coaching, which can be difficult to scale and may not be accessible to all patients.
The AMPLIFY Diet intervention was developed specifically to address these barriers by delivering personalised nutrition and behavioural support entirely online.
A fully automated intervention
The programme operates without live coaching, counselling calls, or face-to-face appointments. Instead, it uses a structured digital platform that includes weekly interactive sessions, goal-setting tools, progress monitoring, and automated personalised feedback.
Participants engage with the system independently, receiving guidance that is grounded in established behavioural and nutritional science. This approach allows for scalability while maintaining a consistent standard of care.
“This is a game changer for cancer survivorship care,” said Wendy Demark-Wahnefried, Ph.D., R.D., senior author and professor at UAB’s School of Health Professions and O’Neal Comprehensive Cancer Center. “We showed that a completely automated online program grounded in decades of behavioral and nutrition science can safely and effectively help cancer survivors lose weight and improve their health at scale.”
Study design and participant profile
Between 2020 and 2024, the study enrolled 349 participants aged between 50 and 82 years from 31 states across the United States. All participants were living with and beyond cancers associated with obesity.
The cohort included individuals with a range of cancer types, including breast, colorectal, prostate, endometrial, ovarian, thyroid, renal, and haematologic cancers. Participants were randomly assigned to either the AMPLIFY Diet programme or a control group receiving standard survivorship information.
Clinically meaningful weight loss outcomes
After six months, the results showed clear differences between the intervention and control groups.
More than 43 percent of participants in the AMPLIFY Diet group achieved weight loss of at least 3 percent of their body weight. In comparison, only 13 percent of those receiving usual care reached this threshold.
In addition, nearly one in three participants in the intervention group lost at least 5 percent of their body weight. This level of weight loss is widely associated with reductions in cardiovascular risk and improvements in cancer-related outcomes.
On average, weight loss in the intervention group was nearly five times greater than that observed in the control group.
Broader health improvements
The benefits of the programme extended beyond weight loss alone. Participants in the AMPLIFY Diet group experienced improvements across multiple domains of health and wellbeing.
These included reductions in waist circumference and overall caloric intake, as well as improvements in diet quality. Biochemical markers also shifted in a favourable direction, with lower circulating levels of leptin, a hormone associated with cancer progression and cardiometabolic disease.
Further gains were observed in blood pressure, physical functioning, and cognitive performance. Participants also reported improvements in depression and their ability to engage in social roles, suggesting a broader impact on quality of life.
Strong engagement without human support
One notable finding from the study was the level of participant engagement. Individuals completed an average of 60 percent of the weekly sessions, which is considerably higher than engagement rates typically reported in other digital lifestyle interventions.
This suggests that a well-designed automated system can maintain user engagement even in the absence of direct human interaction.
Implications for scalable care
Unlike many conventional weight management programmes, the AMPLIFY Diet intervention does not require ongoing staff involvement. This makes it particularly well suited for integration into healthcare systems, cancer centres, and community-based services.
The ability to deliver consistent, evidence-based care at scale may help address longstanding gaps in survivorship support, particularly in settings where specialist resources are limited.
The role of behavioural and nutritional care
The researchers emphasise that lifestyle-based interventions remain a cornerstone of care for people living with and beyond cancer, particularly as pharmacological approaches continue to evolve.
“Behavioral and nutritional interventions are essential,” Demark-Wahnefried said. “Diet quality, muscle preservation, cognition, and long-term sustainability of a healthful lifestyle and body weight are critical for cancer survivors, and even if weight loss medications eventually receive broadscale endorsement, they alone do not address all of these needs.”
Future directions
The research team is now focusing on expanding the reach of the AMPLIFY Diet programme across both clinical and non-clinical settings. The aim is to improve access to effective survivorship care while also contributing to broader cancer prevention efforts.
The study was funded by the National Institutes of Health and the American Cancer Society.
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First UK Long-Distance Robotic Surgery Connects London Surgeon with Gibraltar Patient
Key Takeaways:
- A London-based surgeon has performed the UK’s first long-distance robotic cancer surgery on a patient in Gibraltar, marking a major milestone in telesurgery
- The procedure demonstrated minimal delay and high precision, suggesting remote surgery could expand access to specialist care in underserved regions
- Patients living far from specialist centres may benefit from reduced travel, lower costs and improved continuity of care
A landmark moment in remote surgery
A surgeon based in London has carried out what is believed to be the United Kingdom’s first long-distance robotic surgical procedure, operating on a patient located approximately 1,500 miles (2,400 km) away in Gibraltar.
Professor Prokar Dasgupta, a leading robotic urological surgeon, performed a prostate removal on 62-year-old Paul Buxton. Reflecting on the experience, he said it felt “almost as if I was there”, despite the geographical distance between surgeon and patient.
For Buxton, who is living with prostate cancer, the decision to participate in the procedure was straightforward. He described it as a “no-brainer” and an opportunity to become “part of medical history”.
Expanding access to specialist care
The development of long-distance robotic surgery is seen as a potential solution to longstanding challenges in healthcare access, particularly for people living in remote or underserved regions.
Such approaches could reduce the “vast expense and inconvenience” associated with travelling for specialist treatment, while enabling patients to receive care closer to home.
This milestone builds on previous advances involving UK-based surgical teams. Earlier work included a transatlantic robotic stroke procedure conducted over a distance of 4,000 miles on a cadaver – a body donated to science – which demonstrated that long-distance surgery was technically feasible.
A patient’s perspective
Buxton, originally from Burnham-on-Sea in Somerset, has lived in Gibraltar for four decades. As a British Overseas Territory, Gibraltar has limited healthcare infrastructure, with only one hospital – St Bernard’s Hospital at Europort. Patients requiring more complex care often need to travel abroad, commonly to the United Kingdom for NHS treatment if eligible.
Following his prostate cancer diagnosis shortly after Christmas, Buxton initially expected to join an NHS waiting list. However, he chose instead to take part in the remote surgery trial.
“A lot of people actually said to me: ‘You’re not going to do it, are you?’”
“I thought, I’m giving something back here,” he said.
Buxton also highlighted the practical advantages of the approach:
“If I hadn’t gone for the telesurgery in Gibraltar, then I would have had to have flown to London, I would have had to go on the NHS waiting list, get the procedure done and I would have probably been in London for three weeks.
“So I thought: ‘This is a no-brainer’.
“It is pioneering for Gibraltar, because you don’t need to leave Gibraltar.”
Following the operation on 11 February, he reported a positive recovery, stating he was “really well looked after” and “feeling fantastic”.
How the technology works
The procedure was conducted from The London Clinic using a robotic surgical system equipped with a high-definition 3D camera and four robotic arms. These were controlled remotely via a surgical console.
The connection between London and Gibraltar was enabled through fibre-optic cables, supported by a backup 5G link. The system achieved an extremely low latency, with a delay of just 0.06 seconds, allowing for precise and responsive control.
A surgical team in Gibraltar remained on standby throughout the operation to intervene if necessary, although the connection remained stable for the duration of the procedure.
The operation utilised the Toumai Robotic System and was delivered through a collaboration between The London Clinic and the Gibraltar Health Authority.
Looking ahead: scaling telesurgery
Professor Dasgupta emphasised the broader implications of the innovation:
“This gives us the opportunity to treat patients in remote areas and smaller communities by literally being able to take the best surgeon anywhere.”
The procedure forms part of an initial series of test cases. A second operation involving a 52-year-old patient in Gibraltar was carried out on 4 March, with a further procedure scheduled for 14 March.
The upcoming operation will be live-streamed to 20,000 leading urological surgeons attending the European Association of Urology congress, highlighting the global interest in this emerging field.
Reflecting on the future, Dasgupta added:
“I think it is very, very exciting, the humanitarian benefit is going to be significant.”
Alignment with broader surgical trends
This development sits alongside wider efforts to expand the use of robotic-assisted surgery within the NHS. Current ambitions include scaling up to 500,000 robot-supported operations annually by 2035.
While the NHS is prioritising local access to robotic surgery, advances in telesurgery suggest a complementary pathway – one that could extend specialist expertise beyond physical borders and reshape how surgical care is delivered globally.
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Digital Health Tools Offer Scalable Solutions for Early Childhood Sleep Challenges
Key Takeaways:
- Digital sleep interventions demonstrate meaningful improvements in sleep outcomes for young children, with high levels of parental engagement across diverse formats.
- Parents also benefit, with several studies reporting reduced stress and improved sleep quality alongside improvements in their children’s sleep.
- While early results are promising, gaps remain in long-term evidence, objective sleep measurement and inclusion of families from minority and low-resource communities.
Digital health and early childhood sleep
A new scoping review led by researchers at the University of Miami Miller School of Medicine highlights the growing role of digital tools in helping parents support healthier sleep in early childhood. The review was spearheaded by Azizi Seixas, PhD, and Girardin Jean-Louis, PhD, and describes strong parental engagement, meaningful improvements in sleep outcomes and emerging best practices for future innovation in paediatric sleep health.
Sleep problems in young children, ranging from bedtime resistance and frequent night wakings to obstructive sleep apnoea, are closely linked to multiple aspects of development. Persistent sleep disturbances beyond infancy have been associated with challenges in school readiness, mood regulation and long-term health outcomes. Against this backdrop, the rapid expansion of mobile apps, telehealth services and online learning platforms has positioned digital health as a potentially powerful avenue for supporting families navigating sleep difficulties.
“This study fills an important gap in the pediatric sleep literature by showing how digital tools can capture real-world sleep behaviors at scale,” said Dr Seixas. “From a public health standpoint, these technologies help us identify population-level patterns earlier, especially in communities where sleep problems often go unrecognized. Clinically, they give providers objective, continuous data that can guide more personalized and timely interventions, ultimately improving outcomes for children who need support the most.”
A global review of digital sleep interventions
Dr Seixas, an associate professor of psychiatry and behavioural sciences, director of The Media and Innovation Lab, associate director of the Center for Translational Sleep and Circadian Sciences and interim chair of the Department of Informatics and Health Data Science at the Miller School, and Dr Jean-Louis, professor of psychiatry and behavioural sciences and neurology and director of the Center for Translational Sleep and Circadian Sciences, led an extensive scoping review of the scientific literature.
The research team screened more than 2,100 articles published from database inception through April 2025 across multiple academic sources. Following rigorous screening, 21 studies met the final inclusion criteria.
Collectively, these studies involved thousands of parents, dozens of healthcare professionals and nearly 500 parent-child dyads who participated in digital sleep intervention trials. The breadth of study designs and populations provided a wide-ranging view of how digital approaches are being applied in early childhood sleep support.
Types of digital tools evaluated
The review encompassed a diverse range of digital sleep interventions, including:
- Mobile applications designed to guide bedtime routines and monitor sleep behaviours
- Web-based educational modules for parents
- Telehealth programmes offering remote coaching and behavioural guidance
- Social media-enhanced parent support groups
- Wearable devices and data dashboards used for sleep tracking
- Robotic or kiosk-based sleep education tools
Across all formats, parental engagement emerged as a consistent strength. Most interventions focused on equipping parents with practical strategies to implement at home, often grounded in cognitive-behavioural therapy for insomnia or other evidence-based behavioural approaches.
Improvements in sleep outcomes for children and parents
A majority of the digital interventions reviewed were associated with improvements in at least one clinical sleep outcome for children. In many cases, benefits extended beyond the child to parents and caregivers.
Reported improvements for children included:
- Longer total sleep duration, documented in six studies
- Fewer night wakings
- Shorter sleep onset latency, defined as the time taken to fall asleep
- Improved sleep efficiency
- Reduced early-morning awakenings
- Improved breathing-related symptoms, including snoring detection through mobile tools
Several studies also reported positive effects on parental wellbeing, including reduced stress levels and improvements in parental sleep quality. One mobile application, Dr Lullaby, was associated with a significant reduction in the need for parents to remain in the room while their child fell asleep, suggesting improved sleep independence.
Telehealth and neurodevelopmental conditions
Telehealth interventions were particularly valuable for families of children with autism spectrum disorder. In randomised controlled trials, parents who received remote coaching on behavioural sleep strategies reported significant improvements in their children’s sleep by weeks five and ten of the intervention. These benefits were sustained at 16-week follow-up, indicating potential durability of effect.
Web-based educational programmes also demonstrated value. Online modules such as Mini-KiSS and the SKIP asthma-sleep intervention supported parents in establishing healthier bedtime routines and reducing night-time disruptions. These programmes consistently received high ratings for usability and acceptability among participating families.
The role of social support
The review highlighted the added value of social connection within digital interventions. In one study, an online healthy-lifestyle programme for young children showed no measurable sleep improvements until researchers introduced a closed Facebook group for parents. The addition of peer support facilitated shared problem-solving and encouragement, leading to significant gains in children’s sleep duration.
Gaps and priorities for future research
Despite the encouraging findings, the review identified several important limitations in the current evidence base:
- Approximately half of the studies involved predominantly white families, despite evidence that sleep problems disproportionately affect children from minority backgrounds.
- Most studies focused on short-term outcomes, with limited data on long-term effectiveness.
- Wearable devices were underused as objective measures of sleep.
- Children with chronic health conditions were underrepresented, even though early evidence suggests tailored digital interventions may be particularly effective for these groups.
Implications for clinical care and global paediatric health
Digital sleep health tools are becoming increasingly accessible, engaging and aligned with how families use technology in everyday life. This review suggests that when these tools are thoughtfully designed and grounded in behavioural science, they can meaningfully improve sleep outcomes for young children while also supporting parental wellbeing.
For clinicians, digital interventions may function as scalable extensions of care, offering education, behaviour tracking and reinforcement of healthy nightly routines. For researchers and developers, the next challenge lies in ensuring these tools are inclusive and reach families who may benefit most, particularly those in minority or low-resource communities.
The authors conclude that digital paediatric sleep interventions “show promise to educate parents and improve sleep outcomes in their child, extending benefits to the whole family.” With targeted innovation and equitable implementation, digital sleep solutions could become an integral component of paediatric care worldwide.
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Digital and AI Strategies Emerge as Central to Expanding Health System Capacity, Survey Finds
Key Takeaways:
- Health system leaders increasingly view AI and digital health as essential to expanding capacity without adding buildings or clinical staff.
- Surveyed executives highlight persistent system pressures, including unaffordable care, limited access to primary care, and insufficient management of people’s health and wellbeing.
- Most leaders believe that fundamental operational change, underpinned by AI and digital tools, will be necessary to create sustainable, proactive models of care.
Introduction
A new report from the healthcare advisory firm Chartis suggests that digital health and artificial intelligence are now central pillars in health system leaders’ strategies to expand capacity, improve access, and operate more sustainably. The findings come from the firm’s fifth annual digital transformation survey, conducted in September 2025, which examined the perspectives of 150 health system executives on their progress and priorities in digital transformation.
Persistent pressures on healthcare delivery
The survey underscores the mounting pressures facing health systems today. Executives identified several entrenched challenges that continue to shape healthcare delivery:
- Unaffordable care was cited by 61 per cent of respondents as a major concern.
- Insufficient management of people’s long-term health and wellness was highlighted by 52 per cent.
- Limited timely access to primary care was reported by 49 per cent of leaders.
More than half of surveyed leaders believe that the sustainability of current care delivery models will decline further over the coming five years.
A shift from reactive to proactive care
In response to these pressures, there is widespread agreement that health systems must undergo fundamental change. According to the survey, nine in ten executives feel that organisations need to move away from reactive care and adopt more proactive, anticipatory models.
AI and digital health solutions are now widely considered critical to achieving this shift. The report notes that 90 per cent of leaders are already prioritising investments in digital and AI capabilities to support operational transformation.
AI and digital tools to expand capacity
Executives emphasised the importance of AI and digital health in increasing capacity while avoiding costly infrastructure or workforce expansion. Over the next five years, leaders expect these capabilities to be essential for serving more people without increasing physical space or clinical headcount.
Key priorities include:
- Freeing clinicians’ time for direct care through the use of AI (reported as very important by 52 per cent).
- Maximising access to clinical expertise using digital tools (51 per cent).
- Developing digitally enabled referral channels (45 per cent).
- Building hospital-at-home models as an alternative to inpatient care (36 per cent).
Expanding reach and access to care
Leaders also highlighted a strong need to extend the reach of healthcare services. More than half (53 per cent) stated that expanding delivery through initiatives such as care-at-home or mobile clinics is very important to improving access.
Several digital approaches were identified as particularly valuable for enhancing timely and convenient access:
- AI coaches to answer people’s questions (44 per cent).
- Connected devices and remote diagnostics to gather real-time health data (43 per cent).
- AI-enabled risk prediction to identify emerging health issues (43 per cent).
Supporting personalised patient journeys
Personalisation is another priority area, with leaders recognising the potential of digital platforms and AI to tailor the patient journey. The survey found:
- 52 per cent view offering multiple digital communication channels as very important for personalising the experience.
- 48 per cent believe that enhanced data collection and AI-supported analytics will be key to developing personalised care plans.
Call to action from Chartis
Tom Kiesau, co-author of the report and chief AI and digital officer at Chartis, emphasised the urgency of acting on these insights. He stated in the press release:
“Organisations need to capitalise on the momentum in this moment – and ensure that they are truly realising the potential presented by AI and digital capabilities to drive needed business transformation at scale.”
AI-Supported Telehealth Enhances Hip Surgery Recovery in Regional Australia
Key Takeaways:
- A co-designed, digitally supported recovery pathway is helping people in regional Australia access surgeon-approved post-operative hip care without the need for long-distance travel.
- The Panacea Pathway integrates predictive analytics and AI-generated insights to monitor progress, identify risks early, and support safer and more consistent recovery at home.
- More than 3,000 at-home clinical appointments have been delivered, with patients reporting greater confidence, improved continuity of care, and fewer missed appointments.
Addressing gaps in regional post-operative care
Hip replacement surgery is among Australia’s most frequently performed orthopaedic operations, and the demand for this intervention continues to grow as the population becomes older. However, people living in regional areas remain disproportionately affected by barriers to appropriate post-operative follow-up. Many must travel long distances to attend surgeon or specialist reviews, face reduced access to multidisciplinary care, and often lack the reassurance that accompanies regular in-person monitoring.
Recognising these persistent challenges, the Fortius Institute for Musculoskeletal Research (FIMR), working in partnership with the Sunshine Coast Orthopaedic Group, identified an opportunity to reshape the recovery experience. Together, they developed the Panacea Pathway: a digitally supported, surgeon-approved rapid recovery pathway delivered directly into people’s homes by nurse practitioners through a Nurse Concierge model.
Co-designing a digital recovery service
To turn this concept into a structured clinical pathway, FIMR partnered with the University of the Sunshine Coast to design the Nurse Concierge service specifically for people recovering from hip arthroplasty. This collaboration was supported by the Queensland Government’s Regional University Industry Collaboration (RUIC) programme, delivered by CSIRO, which connects regional universities with small and medium-sized enterprises to facilitate research partnerships across Queensland.
For the Sunshine Coast Orthopaedic Group, the RUIC partnership offered access to advanced research expertise and data capabilities that would not have been available independently. With direct support from the University of the Sunshine Coast, the team was able to gather a broader and more detailed dataset, providing a stronger foundation for training AI tools using real-world clinical information.
This work resulted in a clinical care pathway combining surgeon-approved best practice with at-home delivery by nurse practitioners. The approach integrates predictive analytics and AI-driven insights to remotely monitor each person’s progress, detect early signs of risk, and support timely intervention. In doing so, it reduces the physical and practical burden on patients while promoting safer and more consistent recovery outcomes.
“Seeing our research directly improve patients’ lives has been incredibly rewarding, and this project is demonstrating our approach is leading to safer, better and faster recovery for patients undergoing major orthopaedic surgery,” said Professor Nick Ralph from the University of Sunshine Coast.
He added: “Working alongside clinicians through the RUIC partnership meant we could refine our data collection methods in real-time, building the robust dataset needed to develop an evidence-based care pathway.”
Impact and future direction
Early feedback on the at-home Nurse Concierge service has been highly positive. More than 3,000 at-home clinical appointments have already been completed, substantially reducing travel time for regional participants and resulting in fewer missed follow-up appointments. Many patients reported feeling more confident in their recovery journey, emphasising the value of personalised monitoring and consistent contact with the same nurse practitioner.
“This project has demonstrated how remote care and digital health tools can reimagine the patient journey,” said Dr Stephanie Chaousis, Head of Digital Innovation at FIMR.
“By combining clinical expertise with data-driven insights, we’re not just improving recovery outcomes – we’re establishing a new standard for musculoskeletal care.”
The extensive dataset collected through the programme is now informing further enhancements to the pathway for joint replacement patients. Building on the success of the hip surgery pilot, the Sunshine Coast Orthopaedic Group intends to expand the Panacea Pathway to include knee replacement procedures.
With its strong foundation in real-world data, interdisciplinary collaboration, and AI-enabled monitoring, the Panacea Pathway offers a scalable model that could be adopted across hospital networks. Its principles have the potential to inform future clinical guidelines and broaden access to safer, more equitable recovery pathways for people throughout Australia.
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Digital Tools Show Promise in Schizophrenia Care, Large-Scale Study Finds
Key Takeaways:
- A smartphone app, FOCUS, helped people living with schizophrenia manage symptoms and recovery more effectively.
- External facilitation by digital specialists improved outcomes, including reduced psychiatric emergency visits.
- Researchers highlight that the greatest challenge for digital mental health tools remains real-world adoption.
Evidence grows for mobile mental health support
A major clinical study has found that using a smartphone app to support the treatment of schizophrenia can deliver modest but meaningful improvements in symptoms and recovery outcomes. The research, published in Psychiatric Services, is among the largest trials of its kind examining the impact of digital interventions on people with serious mental illness.
While the research took place in the United States, its findings are relevant globally as health systems, including the NHS, seek innovative ways to expand access to mental healthcare and support self-management outside the clinic.
The FOCUS app: bridging the gap between appointments
The FOCUS app was first launched in 2013 to provide digital support for people living with schizophrenia and related conditions. It offers structured prompts and tools to help users manage symptoms, take medication consistently, improve sleep routines, and practise social and coping skills.
Previous small-scale studies showed early promise, but uptake within mental health services has been limited, reflecting wider challenges in embedding digital tools into routine care.
Comparing models of implementation
The new trial enrolled 274 people receiving care for schizophrenia across 23 community clinics. It tested two models of introducing the FOCUS app into clinical practice:
- External facilitators – digital health specialists who supported multiple clinics and provided guidance to both staff and patients.
- Internal facilitators – trained in-house staff who integrated app use within their own teams and services.
Both methods proved feasible, but patients supported by external facilitators experienced better clinical outcomes, including fewer psychiatric emergency attendances.
Digital tools and the challenge of adoption
“Getting access to a mental health provider can be challenging for patients with serious mental illness,” said Dr Dror Ben-Zeev, clinical psychologist, director of UW Medicine’s BRiTE Center, and the study’s lead author. “Mobile health tools hold enormous potential because we can meet patients where they are. The biggest hurdle today for digital mental health solutions is effective implementation and real-world adoption.”
Each participant in the study was paired with a digital navigator, who had access to the individual’s app data, conducted weekly check-in calls, and communicated key updates to the person’s clinical team.
Ensuring digital solutions deliver real results
“There are so many digital solutions being offered right now,” commented Dr Charissa Fotinos, Washington State Medicaid and behavioural health medical director, who served as an advisor on the project. “It’s important for us, as a payor, to support tools that have evidence of efficacy. We need to pay for things that work.”
Her remarks echo a growing sentiment among UK health commissioners and policymakers: while digital mental health tools hold promise, investment must prioritise those that have been proven to work in practice, not just in theory.
Towards a future of evidence-based digital psychiatry
The study forms part of mHealth Washington, a multi-year programme funded by the National Institute of Mental Health, developed in collaboration with the University of Washington School of Medicine and the Washington State Health Care Authority.
Researchers emphasised the wider relevance of their findings to healthcare systems internationally. As the NHS continues to expand its use of digital therapy tools, from remote cognitive behavioural therapy to AI-assisted triage, evidence such as this may help shape best practice for integrating digital interventions into routine psychiatric care.
Conflict-of-interest statements for the study authors are available in the published paper.
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Study Finds Early Virtual Follow-Up Reduces Hospital Readmissions and Enhances Recovery
Key Takeaways:
- A UC San Diego Health telemedicine clinic reduced 30-day hospital readmissions from 20.1% to 14.9% among high-risk patients.
- The clinic provides rapid, virtual follow-up care after discharge, addressing medication access, care understanding, and specialist coordination.
- Findings suggest that virtual post-discharge care can improve health outcomes, cut costs, and enhance care equity.
Virtual care reduces readmissions in high-risk patients
A new study led by researchers at the University of California San Diego (UC San Diego) School of Medicine has found that a virtual transition of care clinic significantly reduces hospital readmissions among high-risk patients.
Published on 23 September 2025 in JMIR Medical Informatics, the study revealed that the 30-day readmission rate for patients seen in UC San Diego Health’s virtual transition of care clinic was 14.9%, compared with 20.1% in a benchmark group that received standard follow-up care.
“With our virtual transition of care clinic, we are providing patients with the right care, at the right place, at the right time,” said Dr Sarah Horman, lead author of the study and Professor of Medicine at UC San Diego School of Medicine. “With the convenience of meeting virtually, we’re able to reach patients much more efficiently.”
Tackling a national challenge
Hospital readmissions represent a major strain on healthcare systems across the United States, with an estimated annual cost of $17 billion. Recognising this challenge, UC San Diego Health clinicians and leadership launched the virtual clinic in 2021 to improve care coordination immediately following discharge.
The initiative supports clinical management and specialist referrals for people leaving hospital, aiming to reduce the likelihood of complications or unplanned readmissions.
How the virtual transition clinic works
The clinic operates with a team of 12 hospitalists, two medical assistants, one pharmacist, and an on-demand interpreter service. When necessary, visits were converted to telephone consultations to accommodate patients facing technical or connectivity barriers.
Each discharge triggers a standardised hand-off to the patient’s primary care provider and relevant specialists, summarising the reason for admission, ongoing care needs, and follow-up recommendations.
If a patient experienced issues post-discharge, the virtual care team expedited communication with the primary care provider to ensure timely in-person review.
Addressing barriers to follow-up care
“When telemedicine first began, there was concern it would further increase health disparities, especially in vulnerable patient groups,” said Dr Horman, who is also a hospitalist and affiliate faculty member at the Joan and Irwin Jacobs Center for Health Innovation at UC San Diego Health. “However, through our research, we have found the opposite as the virtual clinic reaches patients more effectively.”
Many individuals, she noted, struggle to attend in-person follow-up appointments due to transport issues or mobility limitations. “For example, many patients do not have access to transportation for in-person follow-up visits, so they will often skip them altogether, resulting in an increased risk of hospital readmission. For patients who did not have access to video visits, we coordinated telephone calls instead. In total, the no-show rate for these follow-up visits was less than 5%.”
Strengthening the post-hospital care chain
According to Dr Horman, the clinic targets three critical aspects of post-discharge care:
- Ensuring access to and availability of prescribed medications.
- Supporting patient and caregiver understanding of the care plan.
- Facilitating navigation between primary and specialist care.
“Our goal is to hardwire this linkage in the care chain between the hospital team and primary care in order to help expedite support during that very sensitive, post-hospital period of time,” she explained. “As a result, patient outcomes are improving while they recover at home and hospitals have capacity to take care of the next patient in need of critical care.”
Study scope and findings
The study evaluated more than 25,000 patients discharged from UC San Diego Health between 1 September 2021 and 17 September 2024. Of these, 2,314 were seen in the virtual clinic, while 23,129 received standard care.
Typically, patients see their primary care provider two to four weeks after discharge. However, under this programme, individuals at moderate or high risk were seen within one week.
“Our clinic is a one-time, virtual visit with a patient immediately after their hospital stay to ensure we’re doing all we can to mitigate risk,” added Dr Horman.
Data-driven patient targeting with the LACE+ index
The team used the LACE+ index to identify patients at high risk of readmission or complications. LACE stands for Length of stay, Acuity of admission, Comorbidity, and Emergency department visits. The “+” extends the model to include factors such as age, sex, and previous hospitalisations.
“The use of LACE+ underscores the importance of data-driven and patient-centric strategies in enhancing patient outcomes,” said Dr Horman. “By using this tool, we were able to target follow-up care to those most likely to benefit. This approach helped improve care transitions and reduce avoidable hospital visits.”
Future of the programme
UC San Diego Health’s virtual transition of care clinic continues to operate across Hillcrest and Jacobs Medical Centers, with expansion plans to include East Campus Medical Center.
Dr Horman noted that these findings demonstrate how telemedicine can contribute to broader goals of improving population health, enhancing patient experience, reducing healthcare costs, and advancing care equity.
The study’s co-authors include Milla Kviatkovsky, Edward Castillo, Patricia S. Maysent, Chad VanDenBerg, John Bell, and Christopher A. Longhurst, all from UC San Diego Health.
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