Yale New Haven Hospital is rolling out digital healthcare technology the hospital says boosts activity levels and rehabilitation success for patients getting a new hip or knee.

The hospital’s Center for Musculoskeletal Care is piloting technology from Reflexion Health that creates a “virtual” rehabilitation program for patients to use at home after they are discharged from the hospital following joint replacement surgery.

The digital technology, known as Virtual Exercise Rehabilitation Assistant, or Vera, is a therapy platform designed by Reflexion that integrates a broad menu of rehabilitation exercises, an animated avatar coach and a three- dimensional imaging system for measuring movement and form as patients exercise at home.

Using Vera, patients stand in front of a three-dimensional camera and the avatar demonstrates, detects, measures and analyzes individually prescribed movements while providing helpful feedback to patients along the way. In early use, Vera demonstrated increased patient engagement and improved adherence to prescribed exercises, the hospital says.

The average hospital charge for a knee replacement in the U.S is $49,500 and $39,299 to replace a hip, according to Healthline.com. Of those amounts, post-surgery care can represent about 50% of the total cost, says the hospital.


The hospital is piloting Vera to speed up patient recovery time, boost rehabilitation results by getting patients to do their exercises at home and provide an alternative to more expensive forms of conventional physical therapy, says John Tarutis, the hospital’s executive director of physical medicine and rehabilitation. Yale New Haven didn’t break out costs for the technology.

With conventional physical therapy only about 50% of all new joint patients do their exercises at home. But about a month into a pilot project with Vera involving about 30 patients about 80% of patients are doing their prescribed exercises. “We are looking to drive higher outcomes and deliver better care at a lesser cost,” Tarutis says.

Dr. Mary O’Connor, an orthopedic surgeon and director of the Musculoskeletal Center at Yale School of Medicine and Yale-New Haven Hospital, says she became aware of the Vera digital rehabilitation platform while working at The Mayo Clinic and wanted to implement Vera at Yale New Haven. “The platform keeps patients engaged, connected to their therapist and can track activity,” she says.

Yale New Haven is paying San Diego-based Reflexion an undisclosed amount to license the Vera platform and equipment patients use at home. Reflexion also declines to release any pricing information. But the cost of using the Vera platform and home equipment is free for the joint rehabilitation patients taking part in the pilot.

In the next several months the pilot will expand to include at least 100 patients and incorporate other types of rehabilitation such as for patients undergoing shoulder surgery.


Patients are introduced to Vera while in the hospital and a Vera technician installs the camera and other equipment in the patient’s home before they are discharged. Once home the patient follows a personalized rehabilitation program customized for the Vera platform by a Yale New Haven therapist. When fully recovered a Vera technician then comes to the home to pick up the equipment.

“Patients tell us they like it so far,” Tarutis says.

Based in New Haven, Conn., Yale New Haven Health consists of Bridgeport, Greenwich, Lawrence + Memorial, Yale New Haven and Westerly hospitals, and Northeast Medical Group, a physician foundation of primary care and medical specialists.