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Ahn A, Morgan AU, Burke RE, Honig K, Long JA, McGlaughlin N, Jointer C, Asch DA, Bressman E. Postdischarge needs identified by an automated text messaging program: A mixed-methods study. J Hosp Med 2024. [PMID: 39051626 DOI: 10.1002/jhm.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/18/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Text messaging has emerged as a popular strategy to engage patients after hospital discharge. Little is known about how patients use these programs and what types of needs are addressed through this approach. OBJECTIVE The goal of this study was to describe the types and timing of postdischarge needs identified during a 30-day automated texting program. METHODS The program ran from January to August 2021 at a primary care practice in Philadelphia. In this mixed-methods study, two reviewers conducted a directed content analysis of patient needs expressed during the program, categorizing them along a well-known transitional care framework. We describe the frequency of need categories and their timing relative to discharge. RESULTS A total of 405 individuals were enrolled; the mean (SD) age was 62.7 (16.2); 64.2% were female; 47.4% were Black; and 49.9% had Medicare insurance. Of this population, 178 (44.0%) expressed at least one need during the 30-day program. The most frequent needs addressed were related to symptoms (26.8%), coordinating follow-up care (20.4%), and medication issues (15.7%). The mean (SD) number of days from discharge to need was 10.8 (7.9); there were no significant differences in timing based on need category. CONCLUSIONS The needs identified via an automated texting program were concentrated in three areas relevant to primary care practice and within nursing scope of practice. This program can serve as a model for health systems looking to support transitions through an operationally efficient approach, and the findings of this analysis can inform future iterations of this type of program.
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Affiliation(s)
- Aiden Ahn
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anna U Morgan
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert E Burke
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Katherine Honig
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith A Long
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
| | - Nancy McGlaughlin
- Penn Primary Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Carlondra Jointer
- Penn Primary Care, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - David A Asch
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eric Bressman
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA
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Cracchiolo JR, Tin AL, Assel M, McCready TM, Stabile C, Simon B, Carlsson SV, Vickers AJ, Laudone V. Electronic Patient-Reported Symptoms After Ambulatory Cancer Surgery. JAMA Surg 2024; 159:554-561. [PMID: 38477892 PMCID: PMC10938249 DOI: 10.1001/jamasurg.2024.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 12/09/2023] [Indexed: 03/14/2024]
Abstract
Importance Complex cancer procedures are now performed in the ambulatory surgery setting. Remote symptom monitoring (RSM) with electronic patient-reported outcomes (ePROs) can identify patients at risk for acute hospital encounters. Defining normal recovery is needed to set patient expectations and optimize clinical team responses to manage evolving problems in real time. Objective To describe the patterns of postoperative recovery among patients undergoing ambulatory cancer surgery with RSM using an ePRO platform-the Recovery Tracker. Design, Setting, and Participants In this retrospective cohort study, patients who underwent 1 of 5 of the most common procedures (prostatectomy, nephrectomy, mastectomy, hysterectomy, or thyroidectomy) at the Josie Robertson Surgery Center at Memorial Sloan Kettering Cancer Center from September 2016 to June 2022. Patients completed the Recovery Tracker, a brief ePRO platform assessing symptoms for 10 days after surgery. Data were analyzed from September 2022 to May 2023. Main Outcomes and Measures Symptom severity and interference were estimated by postoperative day and procedure. Results A total of 12 433 patients were assigned 110 936 surveys. Of these patients, 7874 (63%) were female, and the median (IQR) age at surgery was 57 (47-65) years. The survey response rate was 87% (10 814 patients responding to at least 1 of 10 daily surveys). Among patients who submitted at least 1 survey, the median (IQR) number of surveys submitted was 7 (4-8), and each assessment took a median (IQR) of 1.7 (1.2-2.5) minutes to complete. Symptom burden was modest in this population, with the highest severity on postoperative days 1 to 3. Pain was moderate initially and steadily improved. Fatigue was reported by 6120 patients (57%) but was rarely severe. Maximum pain and fatigue responses (very severe) were reported by 324 of 10 814 patients (3%) and 106 of 10 814 patients (1%), respectively. The maximum pain severity (severe or very severe) was highest after nephrectomy (92 of 332 [28%]), followed by mastectomy with reconstruction (817 of 3322 [25%]) and prostatectomy (744 of 3543 [21%]). Nausea (occasionally, frequently, or almost constantly) was common and experienced on multiple days by 1485 of 9300 patients (16%), but vomiting was less common (139 of 10 812 [1%]). Temperature higher than 38 °C was reported by 740 of 10 812 (7%). Severe or very severe shortness of breath was reported by 125 of 10 813 (1%). Conclusions and Relevance Defining detailed postoperative symptom burden through this analysis provides valuable data to inform further implementation and maintenance of RSM programs in surgical oncology patients. These data can enhance patient education, set expectations, and support research to allow iterative improvement of clinical care based on the patient-reported experience after discharge.
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Affiliation(s)
- Jennifer R. Cracchiolo
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Amy L. Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Melissa Assel
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Taylor M. McCready
- Department of Population Health, NYU Grossman School of Medicine, New York, New York
| | - Cara Stabile
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brett Simon
- Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sigrid V. Carlsson
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Urology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Andrew J. Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Vincent Laudone
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Faucheron J, Alao O, Trilling B. What is true ambulatory colectomy? Tech Coloproctol 2024; 28:47. [PMID: 38613641 DOI: 10.1007/s10151-024-02921-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 03/16/2024] [Indexed: 04/15/2024]
Affiliation(s)
- J Faucheron
- University Grenoble Alpes, CNRS, Grenoble INP, TIMC, UMR 5525, VetAgro Sup, 38000, Grenoble, France.
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France.
| | - O Alao
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
| | - B Trilling
- University Grenoble Alpes, CNRS, Grenoble INP, TIMC, UMR 5525, VetAgro Sup, 38000, Grenoble, France
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, 38000, Grenoble, France
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Kabanova D, Moret C, Albaladejo P, Slim K. Is a care pathway for enhanced recovery after colorectal surgery environmentally responsible? J Visc Surg 2024; 161:46-53. [PMID: 38114402 DOI: 10.1016/j.jviscsurg.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
INTRODUCTION Above and beyond the environmentally responsible operating theater, the environmental impact of the pathways of surgically treated patients seems essential but has seldom been considered in the literature. On a parallel track, enhanced recovery programmes (ERP) programs are presently deemed a standard of care. The objective of this review is to determine the carbon footprint of the ERP approach in colorectal surgery. METHOD This a narrative review based on articles referenced in PubMed. Our search was centered on the environmental impact of an ERP in the context of colorectal surgery. A number of measures included in the national and international guidelines were studied. We utilized the terms "carbon footprint", "sustainability", "energy cost", "environmental footprint", "life cycle assessment" AND a key word for each subject found in the ERP recommendations. RESULTS Most ERP measures in the context of colorectal surgery are factually or intuitively virtuous from an ecological standpoint. With a 3-day reduction in average hospital stay resulting from ERP, the program permits a reduction of at least 375kg CO2e/patient (Appendices 1 and 2). The most substantial part of this reduction is achieved during the perioperative period. While some measures, such as short fasting, are ecologically neutral, others (treatment of comorbidities, smoking cessation, hypothermia prevention, antibiotic prophylaxis, laparoscopy, absence of drains or probes, thromboprophylaxis, early feeding and mobilization…) lead to fewer postoperative complications, and can consequently be considered as environmentally responsible. Conversely, other measures, one example being robotic surgery, leave a substantial carbon footprint. CONCLUSION ERP is congruent with two pillars of sustainable development: the social pillar (improved patient recovery, and better caregiver working conditions fostered by team spirit), and the economic pillar (decreased healthcare expenses). While the third, environmental pillar is intuitively present, the low number of published studies remains a limitation to be overcome in future qualitative studies.
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Affiliation(s)
| | | | | | - Karem Slim
- Groupe francophone de Réhabilitation Améliorée après Chirurgie (GRACE), allée du Riboulet, 63110 Beaumont, France
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Faucheron JL, Vincent D, Barbut M, Jacquet-Perrin I, Sage PY, Foote A, Bellier A, Quesada JL, Tidadini F, Trilling B. Abdominal massage to prevent ileus after colorectal surgery. A single-center, prospective, randomized clinical trial: the MATRAC Trial. Tech Coloproctol 2024; 28:42. [PMID: 38517591 DOI: 10.1007/s10151-024-02914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/18/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND There is scarce literature on the effect of mechanical abdominal massage on the duration of ileus after colectomy, particularly in the era of enhanced recovery after surgery (ERAS). The aim of this study was to determine whether abdominal massage after colorectal surgery with anastomosis and no stoma helps toward a faster return of intestinal transit. METHODS This study was a superiority trial and designed as a prospective open-label, single-center, randomized controlled clinical trial with two parallel groups. Patients scheduled to undergo intestinal resection and follow an ERAS protocol were randomly assigned to either the standard ERAS group or the ERAS plus massage group. The primary endpoint was the return of intestinal transit, defined as the first passage of flatus following the operation. Secondary endpoints included time of the first bowel motion, maximal pain, 30 day complications, complications due to massage, anxiety score given by the Hospital Anxiety and Depression (HAD) questionnaire, and quality of life assessed by the EQ-5D-3L questionnaire. RESULTS Between July 2020 and June 2021, 36 patients were randomly assigned to the ERAS group or the ERAS plus massage group (n = 19). Patients characteristics were comparable. There was no significant difference in time to passage of the first flatus between the ERAS group and the ERAS plus abdominal massage group (1065 versus 1389 min, p = 0.274). No statistically significant intergroup difference was noted for the secondary endpoints. CONCLUSION Our study, despite its limitations, failed to demonstrate any advantage of abdominal massage to prevent or even reduce symptoms of postoperative ileus after colorectal surgery. TRIAL REGISTRATION NUMBER 38RC20.021.
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Affiliation(s)
- Jean-Luc Faucheron
- University Grenoble Alpes, CNRS, Grenoble INP, TIMC, UMR 5525, VetAgro Sup, 38000, Grenoble, France.
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France.
| | - Damien Vincent
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Mihaela Barbut
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Isabelle Jacquet-Perrin
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Pierre-Yves Sage
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Alison Foote
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Alexandre Bellier
- Clinical Pharmacology Unit, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France
| | - Jean-Louis Quesada
- Clinical Pharmacology Unit, INSERM CIC1406, Grenoble Alpes University Hospital, Grenoble, France
| | - Fatah Tidadini
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
| | - Bertrand Trilling
- University Grenoble Alpes, CNRS, Grenoble INP, TIMC, UMR 5525, VetAgro Sup, 38000, Grenoble, France
- Colorectal Surgery Unit, Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble Cedex, France
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Monárrez R, Mohamadi A, Drew JM, Abdeen A. Mobile Application's Effect on Patient Satisfaction and Compliance in Total Joint Arthroplasty: A Systematic Review and Meta-analysis. J Am Acad Orthop Surg Glob Res Rev 2023; 7:01979360-202309000-00005. [PMID: 37678829 PMCID: PMC10484373 DOI: 10.5435/jaaosglobal-d-22-00200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 06/15/2023] [Accepted: 07/11/2023] [Indexed: 09/09/2023]
Abstract
Use of mobile applications to improve patient engagement is particularly promising in total joint arthroplasty (TJA) whereby successful outcomes are predicated by patient engagement. In accordance with published guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, studies were searched, screened, and appraised for quality on various search engines. Hedges' g or odds ratios of patient adherence were reported. Twelve studies met the inclusion criteria, and the average age of 9,521 patients included was 60 years. Six studies concluded that mobile applications improved patients' satisfaction, with Hedges' g revealing an effect size of 1.64 (95% confidence interval [CI] 0.90 to 2.37), P < 0.001, in favor of mobile applications increasing patient satisfaction. Six studies reported improvements in compliance demonstrating an odds ratio for improved adherence of 4.57 (95% CI, 1.66 to 12.62), P < 0.001. Two studies reported a reduction in unscheduled office or emergency department visits. With evolving reimbursement policies linked to outcomes paired with the exponentially increasing volume of TJA performed, innovative ways to efficiently deliver high-quality care are in demand. Our systematic review is limited by a dearth of research on the nascent technology, but the available data suggest that mobile applications may enhance patient satisfaction, improve compliance, and reduce unscheduled visits after TJA.
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Affiliation(s)
- Rubén Monárrez
- From the Department of Orthopaedic Surgery (Dr. Mohamadi, Dr. Drew), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (Dr. Monárrez, Dr. Mohamadi, Dr. Drew, and Dr. Abdeen); the Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD (Monárrez); and the Department of Orthopaedic Surgery, Boston Medical Center, Boston, MA (Abdeen)
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McLean KA, Knight SR, Diehl TM, Varghese C, Ng N, Potter MA, Zafar SN, Bouamrane MM, Harrison EM. Readiness for implementation of novel digital health interventions for postoperative monitoring: a systematic review and clinical innovation network analysis. Lancet Digit Health 2023; 5:e295-e315. [PMID: 37100544 DOI: 10.1016/s2589-7500(23)00026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 04/28/2023]
Abstract
An increasing number of digital health interventions (DHIs) for remote postoperative monitoring have been developed and evaluated. This systematic review identifies DHIs for postoperative monitoring and evaluates their readiness for implementation into routine health care. Studies were defined according to idea, development, exploration, assessment, and long-term follow-up (IDEAL) stages of innovation. A novel clinical innovation network analysis used coauthorship and citations to examine collaboration and progression within the field. 126 DHIs were identified, with 101 (80%) being early stage innovations (IDEAL stage 1 and 2a). None of the DHIs identified had large-scale routine implementation. There is little evidence of collaboration, and there are clear omissions in the evaluation of feasibility, accessibility, and the health-care impact. Use of DHIs for postoperative monitoring remains at an early stage of innovation, with promising but generally low-quality supporting evidence. Comprehensive evaluation within high-quality, large-scale trials and real-world data are required to definitively establish readiness for routine implementation.
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Affiliation(s)
- Kenneth A McLean
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Stephen R Knight
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Thomas M Diehl
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Chris Varghese
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Nathan Ng
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mark A Potter
- Colorectal Unit, Western General Hospital, Edinburgh, UK
| | - Syed Nabeel Zafar
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Matt-Mouley Bouamrane
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
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A Mobile Phone App Improves Patient-Physician Communication and Reduces Emergency Department Visits After Colorectal Surgery. Dis Colon Rectum 2023; 66:130-137. [PMID: 34933314 DOI: 10.1097/dcr.0000000000002187] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Emergency visits after colorectal surgery are common and require significant health care resources. However, many visits may be avoidable with alternative access to care. Mobile health technologies can facilitate patient access to health care providers. OBJECTIVE We hypothesized that a mobile app for postdischarge monitoring with patient-provider communication ability would reduce emergency visits after elective abdominopelvic colorectal surgery. DESIGN This is a prospective cohort study with a regression analysis after coarsened exact matching. SETTING The study was conducted at a single colorectal referral center from May 2019 to September 2020. PATIENTS A total of 114 patients were recruited to the intervention and were matched to a retrospective cohort of 608 patients from the 24 months before the study. All patients were managed according to an enhanced recovery pathway. INTERVENTIONS A mobile phone app comprised of patient education material, daily questionnaires assessing postdischarge recovery, and patient-provider chat function was used. MAIN OUTCOME MEASURES The primary outcomes included potentially preventable 30-day emergency visits defined according to a validated algorithm. Secondary outcomes included length of stay, complications, total emergency department visits, readmissions, and app usability. RESULTS Coarsened-exact matching resulted in a matched sample of 94 prospective intervention patients and 256 retrospective control patients. The prospective group was associated with fewer preventable emergency department visits (incidence rate ratio 0.34; p = 0.043) and shorter length of stay (-1.62 days; p = 0.011). There were no differences in 30-day complications, total number of emergency visits, or readmissions. Patient-reported usability of the mobile app was high, with 88% of patients reporting that the app improved their ability to communicate with their surgeon. LIMITATIONS We did not account for patient activation or perform a cost-analysis. CONCLUSION Use of a mobile app was associated with fewer potentially preventable emergency visits and shorter length of stay after major elective colorectal surgery, which may be due to enhanced postdischarge monitoring and patient-provider communication. See Video Abstract at http://links.lww.com/DCR/B878 . APLICACIN DE TELFONO MVIL MEJORA LA COMUNICACIN ENTRE MDICO Y PACIENTE Y REDUCE LAS VISITAS AL DEPARTAMENTO DE EMERGENCIAS DESPUS DE CIRUGA COLORECTAL ANTECEDENTES:Las visitas de emergencia después de la cirugía colorrectal son frecuentes y requieren importantes recursos sanitarios. Sin embargo, muchas visitas pueden evitarse con un acceso alternativo a la atención. Las tecnologías de salud móviles pueden facilitar el acceso de los pacientes a los proveedores de atención médica.OBJETIVO:Se planteó la hipótesis de que una aplicación móvil para el seguimiento posterior al alta con capacidad de comunicación entre el paciente y el médico reduciría las visitas de emergencia después de cirugía colorrectal abdominopélvica electiva.DISEÑO:Este es un estudio de cohorte prospectivo con un análisis de regresión después de un emparejamiento exacto aproximado.ENTORNO CLINICO:El estudio se llevó a cabo en un solo centro de referencia colorrectal entre 05/2019 y 09/2020.PACIENTES:Se reclutó un total de 114 pacientes para la intervención y se emparejaron con una cohorte retrospectiva de 608 pacientes de los 24 meses anteriores al estudio. Todos los pacientes fueron tratados con protocolo de enhanced recovery .INTERVENCIONES:Se utilizó una aplicación para teléfono móvil compuesta de material educativo para el paciente, cuestionarios diarios que evalúan la recuperación posterior al alta y una función de chat entre el paciente y el médico.PRINCIPALES MEDIDAS DE RESULTADO:Los resultados primarios incluyeron visitas a la emergencia en 30 días potencialmente prevenibles, definidas según un algoritmo validado. Los resultados secundarios incluyeron la duración de la estancia, complicaciones, total de visitas al departamento de emergencias, reingresos y la usabilidad de la aplicación.RESULTADOS:El emparejamiento aproximado-exacto resultó en una muestra emparejada de 94 APP + y 256 APP-. APP + se asoció con menos visitas evitables al servicio de urgencias (IRR 0,34, p = 0,043) y una estancia más corta (-1,62 días, p = 0,011). No hubo diferencias en las complicaciones a los 30 días, número total de visitas de emergencia y reingresos. La usabilidad de la aplicación móvil informada por los pacientes fue alta, y el 88% de los pacientes informaron que la aplicación mejoró su capacidad para comunicarse con su cirujano.LIMITACIONES:No contabilizamos la activación del paciente ni realizamos un análisis de costos.CONCLUSIÓNES:El uso de una aplicación móvil se asoció con menos visitas a la emergencia potencialmente prevenibles y una estadía más corta después de una gran cirugía colorrectal electiva, lo que puede deberse a una mejor monitorización posterior al alta y a la comunicación entre el paciente y el médico. Consulte Video Resumen en http://links.lww.com/DCR/B878 . (Traducción-Dr. Francisco M. Abarca-Rendon ).
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Sine K, Appaneal H, Dosa D, LaPlante KL. Antimicrobial Prescribing in the Telehealth Setting: Framework for Stewardship During a Period of Rapid Acceleration Within Primary Care. Clin Infect Dis 2022; 75:2260-2265. [PMID: 35906829 PMCID: PMC9384578 DOI: 10.1093/cid/ciac598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/12/2022] [Accepted: 07/15/2022] [Indexed: 01/19/2023] Open
Abstract
Antibiotic resistance is a global public health threat. The use of telehealth in primary care presents unique barriers to antimicrobial stewardship, including limited physical examination and changes to the patient-provider relationship. Since the coronavirus disease 2019 (COVID-19) pandemic, there is a need to identify novel antimicrobial stewardship strategies with an explosion in the use of telehealth within primary care. Our review proposes a tailored, sustainable approach to antimicrobial prescribing in the telehealth setting based on the Centers for Disease Control and Prevention's Core Elements of Outpatient Antibiotic Stewardship: commitment, action for policy and practice; tracking and reporting; and education and expertise. The rapid growth of telehealth for all types of primary care visits (not just antibiotic use) is outpacing knowledge associated with strategies for antimicrobial stewardship. Improving antibiotic use within primary care settings is critical as telehealth will remain a priority whether the COVID-19 pandemic recedes, particularly within patient populations with limited access to healthcare.
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Affiliation(s)
- Kathryn Sine
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Haley Appaneal
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Department is College of pharmacy, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
| | - David Dosa
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Department is College of pharmacy, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
- Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, RI School of Public Health, Brown University, Providence, RI, USA
| | - Kerry L LaPlante
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Division of Infectious Diseases, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department is College of pharmacy, College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA
- Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, RI School of Public Health, Brown University, Providence, RI, USA
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Implementation of electronic messaging protocol for pediatric urology preoperative scheduling: A pilot study. J Pediatr Urol 2022; 18:789.e1-789.e6. [PMID: 35474162 DOI: 10.1016/j.jpurol.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Preparing patients for surgery is a task healthcare organizations strive to optimize. Electronic messaging (EM) provides an opportunity for streamlining components of this arduous process. Our study aims to evaluate our early experience in utilizing EM to provide preoperative information to pediatric urology patients. OBJECTIVE To assess the effectiveness of EM in preparing patients for pediatric urologic surgery. STUDY DESIGN This study compared a 6-week pilot program of EM (Figure 1) with traditional nurse phone calls (NPC) in preoperative instruction of pediatric urology patients. The same preoperative instructional information was provided via either source. Data collected included time and resources used by the healthcare system and patient/parent satisfaction. RESULTS The EM group included 98 patients, while the NPC group included 212 patients. Case cancellation rate between the two cohorts was similar, with a 6.67% cancellation rate in the EM cohort and a 10.55% cancellation rate in the NPC cohort (z = -1.137, p = 0.25). There were 4 EM-related operating room delays with an average case delay of 31.5 min (5-60 min). Twenty-four (24%) EM patients/families required secondary phone calls, while 106 (50%) NPC required a follow up phone call (p < 0.01). 94% of EM participants recommended EM for future perioperative instructions. Accounting for the average case volume within our entire children's hospital, the average total daily cost for EM is $5.96/day, as compared to an average total cost of $87.78/day to perform NPC. This represents an estimated cost savings of $81.82 per day or $21,273.20 per year, based upon average total case volume at our institution. DISCUSSION In our initial experience, EM effectively communicates the necessary preoperative information to patients and/or families undergoing pediatric urology surgery. Our results demonstrate low case cancellation and delay rates and high patient/family satisfaction. Also demonstrated was the cost savings by replacing the NPC with EM. A great benefit of EM was the increased time it provided for nurses to perform other patient care duties, which is important given our current nationwide nursing shortage. Limitations of the study included a narrow scope assessing only pediatric urology patients as well as a short study period. Further studies will further define and refine the role of perioperative EM. CONCLUSION Changing to an EM system for preoperative instructions in the pediatric urology population met with a high degree of patient satisfaction and decreased costs for healthcare systems without increasing case delay or cancellation rates.
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Popeskou SG, Christou N, Panteleimonitis S, Langford E, Qureshi T, Parvaiz A. Safety and Feasibility of a Discharge within 23 Hours after Colorectal Laparoscopic Surgery. J Clin Med 2022; 11:jcm11175068. [PMID: 36078996 PMCID: PMC9456718 DOI: 10.3390/jcm11175068] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Enhanced or accelerating recovery programs have significantly reduced hospital length stay after elective colorectal interventions. Our work aims at reporting an initial experience with ambulatory laparoscopic colectomy (ALC) to assess the criteria of discharge and outcomes. Methods: Between 2006 and 2016, data regarding patients having benefited from elective laparoscopic colorectal resections in two main centres in the United Kingdom have been analysed. Both benign and malignant pathologies were included. A standardised enhanced recovery program was performed for each patient, except epidural analgesia was replaced with single shot spinal infiltration. Patients were followed up through a telephone call system by a nurse. Short-term clinical outcomes were analysed. Results: A total of 833 patients were included and 51 (6.1%) were discharged within 24 h following surgery. Of these, 4 out of 51 (7.8%) patients came back hospital within 30 days of discharge; 2 (3.9%) required reoperation (Small bowel obstruction and wound abscess drainage). Conclusions: This study highlights that a 24-h discharge following elective laparoscopic colorectal interventions seems safe and feasible in selected patients. Although challenging to achieve, a standardised approach to laparoscopic surgery in combination with strict adherence to an enhanced recovery protocol are the fundamental elements of this path.
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Affiliation(s)
| | - Niki Christou
- Digestive Surgery Department, University Hospital Limoges, 87000 Limoges, France
- Department of Colorectal Surgery, Queen Elisabeth Hospital, Mindelsohn Way, Birmingham B15 2TH, UK
- Correspondence:
| | - Sofoklis Panteleimonitis
- Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK
- School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth PO1 2FR, UK
| | - Ed Langford
- Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK
| | - Tahseen Qureshi
- Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK
| | - Amjad Parvaiz
- Poole Hospital NHS Trust, Longfleet Road, Poole BH15 2JB, UK
- School of Health Sciences and Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth PO1 2FR, UK
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12
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Singh H, Tang T, Steele Gray C, Kokorelias K, Thombs R, Plett D, Heffernan M, Jarach CM, Armas A, Law S, Cunningham HV, Nie JX, Ellen ME, Thavorn K, Nelson MLA. Recommendations for the Design and Delivery of Transitions-Focused Digital Health Interventions: Rapid Review. JMIR Aging 2022; 5:e35929. [PMID: 35587874 PMCID: PMC9164100 DOI: 10.2196/35929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Older adults experience a high risk of adverse events during hospital-to-home transitions. Implementation barriers have prevented widespread clinical uptake of the various digital health technologies that aim to support hospital-to-home transitions. Objective To guide the development of a digital health intervention to support transitions from hospital to home (the Digital Bridge intervention), the specific objectives of this review were to describe the various roles and functions of health care providers supporting hospital-to-home transitions for older adults, allowing future technologies to be more targeted to support their work; describe the types of digital health interventions used to facilitate the transition from hospital to home for older adults and elucidate how these interventions support the roles and functions of providers; describe the lessons learned from the design and implementation of these interventions; and identify opportunities to improve the fit between technology and provider functions within the Digital Bridge intervention and other transition-focused digital health interventions. Methods This 2-phase rapid review involved a selective review of providers’ roles and their functions during hospital-to-home transitions (phase 1) and a structured literature review on digital health interventions used to support older adults’ hospital-to-home transitions (phase 2). During the analysis, the technology functions identified in phase 2 were linked to the provider roles and functions identified in phase 1. Results In phase 1, various provider roles were identified that facilitated hospital-to-home transitions, including navigation-specific roles and the roles of nurses and physicians. The key transition functions performed by providers were related to the 3 categories of continuity of care (ie, informational, management, and relational continuity). Phase 2, included articles (n=142) that reported digital health interventions targeting various medical conditions or groups. Most digital health interventions supported management continuity (eg, follow-up, assessment, and monitoring of patients’ status after hospital discharge), whereas informational and relational continuity were the least supported. The lessons learned from the interventions were categorized into technology- and research-related challenges and opportunities and informed several recommendations to guide the design of transition-focused digital health interventions. Conclusions This review highlights the need for Digital Bridge and other digital health interventions to align the design and delivery of digital health interventions with provider functions, design and test interventions with older adults, and examine multilevel outcomes. International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2020-045596
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,March of Dimes Canada, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Terence Tang
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carolyn Steele Gray
- Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Kristina Kokorelias
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Rachel Thombs
- Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Donna Plett
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Matthew Heffernan
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carlotta M Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alana Armas
- March of Dimes Canada, Toronto, ON, Canada.,Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Susan Law
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Jason Xin Nie
- Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Moriah E Ellen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Michelle LA Nelson
- March of Dimes Canada, Toronto, ON, Canada.,Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Nittari G, Savva D, Tomassoni D, Tayebati SK, Amenta F. Telemedicine in the COVID-19 Era: A Narrative Review Based on Current Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5101. [PMID: 35564494 PMCID: PMC9105428 DOI: 10.3390/ijerph19095101] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 02/04/2023]
Abstract
During the recent COVID-19 pandemic, healthcare providers have been encouraged to increase their use of telemedicine and to adopt telemedicine platforms for the majority of their clients who have chronic illnesses. Due to the outbreak itself, almost all countries worldwide were placed under emergency lockdowns. In this paper, we reviewed the literature regarding the use of telemedicine during the COVID-19 pandemic. Consequentially, we identified the adoption of telemedicine in various countries worldwide and evaluated their future steps in order to increase the adoption of e-health technologies. As a result of COVID-19, the e-health agenda, especially telemedicine, has been accelerated in several countries. COVID-19 is affecting individuals' daily lives and has created major difficulties in the management of healthcare facilities for both infected and non-infected patients. A large portion of the rapid increase in the use of telemedicine can be attributed to evidence from previous pandemics as well as progress made by the field in response to COVID-19, especially in industrialized countries. A lack of effective treatment, large numbers of unvaccinated individuals, as well as social distancing and lockdown measures suggest telemedicine is the safest and most appropriate way of working with patients and doctors. In spite of this willingness, a large number of barriers need to be overcome in order for the telemedicine system to function properly and effectively throughout countries. In order for telemedicine to be sustainable and beneficial beyond the pandemic, several technical, educational, infrastructure, legal, and economic issues must be addressed and solved.
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Affiliation(s)
- Giulio Nittari
- School of Pharmaceutical Sciences and Health Products, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, MC, Italy; (S.K.T.); (F.A.)
| | - Demetris Savva
- Plastic Reconstructive and Aesthetic Surgery, Nicosia General Hospital, Nicosia-Limassol Old Road 215, Nicosia 2029, Cyprus;
| | - Daniele Tomassoni
- School of Biosciences and Veterinary Medicine, University of Camerino, Via Gentile III da Varano, 62032 Camerino, MC, Italy;
| | - Seyed Khosrow Tayebati
- School of Pharmaceutical Sciences and Health Products, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, MC, Italy; (S.K.T.); (F.A.)
| | - Francesco Amenta
- School of Pharmaceutical Sciences and Health Products, University of Camerino, Via Madonna delle Carceri, 9, 62032 Camerino, MC, Italy; (S.K.T.); (F.A.)
- Research Department, International Radio Medical Centre (C.I.R.M.), Via dell’Architettura 41, 00144 Rome, RM, Italy
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A WeChat-Based Mobile Platform for Perioperative Health Education for Gastrointestinal Surgery. Emerg Med Int 2021; 2021:6566981. [PMID: 34868685 PMCID: PMC8639266 DOI: 10.1155/2021/6566981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022] Open
Abstract
Appropriately instructing and guiding patients before and after surgery is essential for their successful recovery. In recent years, however, the development of the enhanced recovery after surgery (ERAS) protocol has restricted the opportunity for healthcare professionals to spend time with their patients before and after surgery because of efficiency-driven, shortened hospital stay. Here, we embedded health education information of the perioperative period for gastrointestinal surgery on a WeChat-based mobile platform and evaluated the platform through medical staff evaluation, patient volunteer evaluation, and quantitative grading rubric. Clinicians and nurses believed that the mobile platform was attractively designed and easy to navigate, valuable, and adequate for patient health education. The content of health education was embedded into the WeChat-based mobile platform, thereby allowing patients and caregivers to access information at their own pace and enable repeat reading.
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15
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Knight SR, Ng N, Tsanas A, Mclean K, Pagliari C, Harrison EM. Mobile devices and wearable technology for measuring patient outcomes after surgery: a systematic review. NPJ Digit Med 2021; 4:157. [PMID: 34773071 PMCID: PMC8590052 DOI: 10.1038/s41746-021-00525-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/23/2021] [Indexed: 12/11/2022] Open
Abstract
Complications following surgery are common and frequently occur the following discharge. Mobile and wearable digital health interventions (DHI) provide an opportunity to monitor and support patients during their postoperative recovery. Lack of high-quality evidence is often cited as a barrier to DHI implementation. This review captures and appraises the current use, evidence base and reporting quality of mobile and wearable DHI following surgery. Keyword searches were performed within Embase, Cochrane Library, Web of Science and WHO Global Index Medicus databases, together with clinical trial registries and Google scholar. Studies involving patients undergoing any surgery requiring skin incision where postoperative outcomes were measured using a DHI following hospital discharge were included, with DHI defined as mobile and wireless technologies for health to improve health system efficiency and health outcomes. Methodological reporting quality was determined using the validated mobile health evidence reporting and assessment (mERA) guidelines. Bias was assessed using the Cochrane Collaboration tool for randomised studies or MINORS depending on study type. Overall, 6969 articles were screened, with 44 articles included. The majority (n = 34) described small prospective study designs, with a high risk of bias demonstrated. Reporting standards were suboptimal across all domains, particularly in relation to data security, prior patient engagement and cost analysis. Despite the potential of DHI to improve postoperative patient care, current progress is severely restricted by limitations in methodological reporting. There is an urgent need to improve reporting for DHI following surgery to identify patient benefit, promote reproducibility and encourage sustainability.
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Affiliation(s)
- Stephen R Knight
- Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - Nathan Ng
- School of Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Kenneth Mclean
- Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Claudia Pagliari
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ewen M Harrison
- Surgical Informatics, Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
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16
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Romeiser JL, Cavalcante J, Richman DC, Singh SM, Liang X, Pei A, Sharma S, Lazarus Z, Gan TJ, Bennett-Guerrero E. Comparing Email, SMS, and Concurrent Mixed Modes Approaches to Capture Quality of Recovery in the Perioperative Period: Retrospective Longitudinal Cohort Study. JMIR Form Res 2021; 5:e25209. [PMID: 34734827 PMCID: PMC8603163 DOI: 10.2196/25209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 02/25/2021] [Accepted: 09/23/2021] [Indexed: 01/22/2023] Open
Abstract
Background As patients are discharged from the hospital more quickly, the ability to monitor patient recovery between hospital discharge and the first follow-up clinic visit is becoming increasingly important. Despite substantial increase in both internet use and smartphone ownership over the past 5 years, clinicians have been slow to embrace the use of these devices to capture patient recovery information in the period between hospital discharge and the first clinical follow-up appointment. Objective This study aims to investigate the generalizability of using a web-based platform to capture patient recovery in a broad surgical patient population and compare response rates for 3 different web-based strategies for delivering recovery surveys over the perioperative period: email, SMS text messaging, and a concurrent mixed approach of using both email and SMS text messaging. Methods Patients undergoing surgeries managed with an enhanced recovery after surgery pathway were asked to participate in a web-based quality assurance monitoring program at the time of their preoperative surgery appointment. Different follow-up methods were implemented over 3 sequential phases. Patients received Health Insurance Portability and Accountability Act–compliant web-based survey links via email (phase 1), SMS text messaging (phase 2), or concurrently using both email and SMS text messaging (phase 3) using REDCap and Twilio software. Recovery assessments using the established Quality of Recovery-9 instrument were performed 4 days before surgery and at 7 and 30 days postoperatively. Generalizability of the web-based system was examined by comparing characteristics of those who participated versus those who did not. Differences in response rates by the web-based collection method were analyzed using adjusted models. Results A total of 615 patients were asked to participate, with 526 (85.5%) opting for the follow-up program. Those who opted in were younger, slightly healthier, and more likely to be in a partnership. The concurrent mixed modes method was the most successful for obtaining responses at each time point compared with text or email alone (pre: 119/160, 74.4% vs 116/173, 67.1% vs 56/130, 43.1%, P<.001; 7 days: 115/172, 66.9% vs 82/164, 50.0% vs 59/126, 46.8%, P=.001; 30 days: 152/234, 65.0% vs 52/105, 49.5% vs 53/123, 43.1%, P=.001, respectively). In the adjusted model, the concurrent mixed modes method significantly predicted response compared with using email alone (odds ratio 3.4; P<.001) and SMS text messaging alone (odds ratio 1.9; P<.001). Additional significant predictors of response were race, partnership, and time. Conclusions For internet users and smartphone owners, electronic capture of recovery surveys appear to be possible through this mechanism. Discrepancies in both inclusion and response rates still exist among certain subgroups of patients, but the concurrent approach of using both email and text messages was the most effective approach to reach the largest number of patients across all subgroups.
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Affiliation(s)
- Jamie L Romeiser
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - James Cavalcante
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Deborah C Richman
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Sunitha M Singh
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Xiaohui Liang
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Allison Pei
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Samanvaya Sharma
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Zoe Lazarus
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Tong J Gan
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
| | - Elliott Bennett-Guerrero
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, United States
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17
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Goehner D, Kandregula S, Birk H, Carroll CP, Guthikonda B, Kosty JA. Improving patient care in neurosurgery through postoperative telephone calls: a systematic review and lessons from all surgical specialties. Neurosurg Focus 2021; 51:E5. [PMID: 34724638 DOI: 10.3171/2021.8.focus21410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/25/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Postoperative telephone calls are a simple intervention that can be used to improve communication with patients, potentially affecting patient safety and satisfaction. Few studies in the neurosurgical literature have examined the effect of a postoperative telephone call on patient outcomes, although several exist across all surgical specialties. The authors performed a systematic review and analyzed studies published since 2000 to assess the effect of a postoperative telephone call or text message on patient safety and satisfaction across all surgical specialties. METHODS A search of PubMed-indexed articles was performed on June 12, 2021, and was narrowed by the inclusion criteria of studies from surgical specialties with > 50 adult patients published after 1999, in which a postoperative telephone call was made and its effects on safety and satisfaction were assessed. Exclusion criteria included dental, medical, and pediatric specialties; systematic reviews; meta-analyses; and non-English-language articles. Dual review was utilized. RESULTS Overall, 24 articles met inclusion criteria. The majority reported an increase in patient satisfaction scores after a postoperative telephone call was implemented, and half of the studies demonstrated an improvement in safety or outcomes. CONCLUSIONS Taken together, these studies demonstrate that implementation of a postoperative telephone call in a neurosurgical practice is a feasible way to enhance patient care. The major limitations of this study were the heterogeneous group of studies and the limited neurosurgery-specific studies.
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Affiliation(s)
- Dylan Goehner
- 1University of Massachusetts Medical School, Department of General Surgery, Worcester, Massachusetts
| | - Sandeep Kandregula
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Harjus Birk
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Christopher P Carroll
- 3Department of Brain & Spine Surgery, Naval Medical Center, Portsmouth, Virginia; and.,4Department of Surgery, Division of Neurosurgery, Uniformed Services University, Bethesda, Maryland
| | - Bharat Guthikonda
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
| | - Jennifer A Kosty
- 2Louisiana State University Health Shreveport School of Medicine, Department of Neurosurgery, Shreveport, Louisiana
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Ruel M, Ramirez Garcia M, Arbour C. Transition from hospital to home after elective colorectal surgery performed in an enhanced recovery program: An integrative review. Nurs Open 2021; 8:1550-1570. [PMID: 34102021 PMCID: PMC8186688 DOI: 10.1002/nop2.730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/29/2020] [Accepted: 10/27/2020] [Indexed: 12/14/2022] Open
Abstract
AIM This study aimed to investigate the transition from hospital to home after elective colorectal surgery performed in an Enhanced Recovery After Surgery (ERAS) programme. DESIGN An integrative review. METHODS A search of ten electronic databases was conducted. Data extraction and quality assessment were performed independently by two authors. Data analysis and synthesis were based on Meleis' Transitions Theory (2010). RESULTS Forty-two articles were included, and most (N = 27) were of good or very good quality. The researchers identified five categories to document the nature of transition postsurgery, three conditions affecting such transition, eleven indicators informing about the quality of the transition and several nursing interventions. Overall, this review revealed that the transition from hospital to home after ERAS colorectal surgery is complex. A holistic understanding of this phenomenon may help nurses to recognize what they need to do to optimize the in-home recovery of this clientele.
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Affiliation(s)
| | - Maria‐Pilar Ramirez Garcia
- Faculty of NursingUniversité de MontréalMontréalQCCanada
- Research CenterCentre Hospitalier de l’Université de MontréalMontréalQCCanada
| | - Caroline Arbour
- Faculty of NursingUniversité de MontréalMontréalQCCanada
- Research CenterHôpital du Sacré‐Cœur de MontréalCIUSSS du Nord‐de‐l’Île‐de‐MontréalMontréalQCCanada
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Buck C, Keweloh C, Bouras A, Simoes EJ. Efficacy of Short Message Service Text Messaging Interventions for Postoperative Pain Management: Systematic Review. JMIR Mhealth Uhealth 2021; 9:e20199. [PMID: 34132646 PMCID: PMC8277313 DOI: 10.2196/20199] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 12/19/2020] [Accepted: 04/13/2021] [Indexed: 01/20/2023] Open
Abstract
Background Addiction to opiates and synthetic opioids poses a major threat to public health worldwide, with pharmaceutical opioids prescribed to manage pain constituting the main problem. To counteract this threat, suitable pain management strategies should be implemented in health care. Monitoring pain management seems to be feasible using telemedicine with a certain degree of resource intensity and digitization. As a communication channel for this type of monitoring, SMS appears to be a valid alternative. Objective The aim of this systematic literature review was to (1) provide information on the state of research regarding postoperative pain management via SMS, (2) establish a basic understanding of SMS-based pain management, and (3) provide insight into the feasibility of these management strategies. The research question was as follows: Is postoperative pain management feasible and effective utilizing SMS? Methods A systematic literature review was performed mainly following the PRISMA guidelines and another guide on performing a systematic literature review for information systems–related research. A search string was developed based on the objectives and research question, and eight databases were searched. Results The initial search resulted in 2083 records, which could be narrowed down by applying various exclusion criteria. Thereby, 11 articles were identified as relevant, which were accordingly analyzed and evaluated by full-text screening. In all articles, pain management interventions were performed using SMS communication between health care professionals and patients or their legal guardians. A prospective approach was predominantly chosen as the study design (91%) with the leading research objective of determining the intervention’s feasibility (73%). The primary reason for sending SMS messages was to monitor patients (64%). Overall, the use of SMS improved adherence, acceptance, and satisfaction regarding postoperative pain management. With an average response rate of approximately 89.5% (SD 3.8%), the reliability of SMS as a communication and monitoring tool was further emphasized. This response rate is significantly higher than that for email interventions (66.63%, P<.001). Conclusions This study provides a comprehensive picture of the current status on postoperative pain management by SMS. Communication via SMS was beneficial in all interventions, even preoperative. Six SMS interventions could be certified by the respective institutional review board and three were Health Insurance Portability and Accountability Act–compliant. Therefore, the results of this study could be leveraged to address the opioid epidemic. Overall, the research question could be confirmed. Future research should extend this systematic literature review regarding preoperative pain management. Based on these findings, a pre- and postoperative communication model should be developed to address the opioid epidemic effectively.
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Affiliation(s)
- Christoph Buck
- School of Business and Economics, Philipps-Universität Marburg, Marburg, Germany.,Project Group Business and Information Systems Engineering, Fraunhofer Institute for Applied Information Technology FIT, Bayreuth, Germany
| | | | - Adam Bouras
- School of Medicine, University of Missouri, Columbia, MO, United States
| | - Eduardo J Simoes
- School of Medicine, University of Missouri, Columbia, MO, United States
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Dahl M, Morocco E, Rodriguez L, Dancz CE. Acceptability of Text Messaging and Disparities in Mobile Health Access in Women's Health Care: A Survey Study. Telemed J E Health 2021; 27:866-873. [PMID: 33999723 DOI: 10.1089/tmj.2020.0516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective: Few studies in women's health care have utilized text messaging as a data collection tool. Our aims were to (1) determine the willingness of Obstetrics and Gynecology (Ob/Gyn) patients to participate in text message surveys, (2) determine the patient-preferred mode of survey distribution, (3) compare preferences between a low-resource and university population, and (4) review the practical aspects of implementing text message surveys. Methods: Paper surveys were distributed to Ob/Gyn clinic patients at two academic centers. English and Spanish speakers were included. Questions assessed sociodemographic data, survey preferences, and text messaging preferences. Appropriate tests were used to look for associations between demographics and survey preferences. Results: One hundred eighty-two participants completed the survey. Respondents were seen at either a university (42%) or a safety net (58%) clinic. Most owned a mobile phone (94%), used text messaging everyday (88%), and had an unlimited data plan (83%). Of the respondents willing to participate in a survey, text messaging was the preferred survey method (70%), followed by phone (14%) and mobile applications (8%). Fifty-six percent of respondents were willing to participate in a daily text message survey. There were no associations between socioeconomic status and survey preferences or willingness to participate in text message surveys. Survey preference was associated with age (p < 0.01). Respondents of all age groups preferred text message surveys; however, those aged 31-60 years were most likely to prefer text messaging (odds ratio: 8.3, confidence interval: 2.6-29.8). Conclusions: Most Ob/Gyn patients are willing and able to participate in text message surveys, and text messaging is the most preferred survey method across sociodemographic categories.
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Affiliation(s)
- Molly Dahl
- Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Elise Morocco
- Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Larissa Rodriguez
- Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Christina E Dancz
- Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of Southern California, Los Angeles, California, USA
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High incidence of potentially preventable emergency department visits after major elective colorectal surgery. Surg Endosc 2021; 36:2653-2660. [PMID: 33959806 DOI: 10.1007/s00464-021-08514-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/17/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Emergency department (ED) visits after surgery represent a significant cost burden on the healthcare system. Furthermore, many ED visits are related to issues of healthcare delivery services and may be avoidable. Few studies have assessed the reasons for ED visits after colorectal surgery. The main objectives of this study were to: (1) identify the reasons why patients presented to the ED within 30 postoperative days and (2) determine if these visits were potentially preventable. METHODS A retrospective chart review was conducted on elective major colorectal surgery cases performed in a single center between 01/2017 and 07/2019. Data collected included demographics, medical history, intraoperative details, postoperative complications, ED visits within 30 postoperative days, and readmissions. Each ED visit was assessed by two reviewers and graded on a scale adapted from the New York University ED algorithm. The gradings were: (1) non-emergent, (2) emergent but treatable in an ambulatory setting, (3) emergent/ED-care required but preventable if timely outpatient care was available, and (4) emergent/ED-care required and non-preventable. Grades 1-3 were deemed potentially preventable. Logistic regression identified independent predictors of potentially preventable visits. RESULTS Six hundred and twenty five patients were included in the final analysis. 110 (17.6%) patients presented to the ED within 30 days. The most common cause of ED visit were ileus/small bowel obstruction (SBO) (16.4%), superficial wound infection (15.5%), genitourinary issues (10.9%), and non-infectious gastrointestinal issues (nausea, malnutrition, diarrhea, high output stomas) (10.9%). After review, 51.8% of visits were considered potentially preventable (Grade 1-3). The most common causes of preventable ED visits were superficial wound infection (24.6%), non-infectious gastrointestinal issues (19.3%), and minor bleeding (14.0%). Creation of a new stoma was the only independent risk factor for potentially preventable ED visits (OR 2.14, 95%CI 1.03-4.47). CONCLUSION Approximately half of ED visits within 30 days of discharge were potentially preventable. These findings indicate a need to improve access to outpatient care to reduce preventable ED visits after elective colorectal surgery.
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22
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Digital tools for ambulatory surgery patient surveillance and beyond…. J Visc Surg 2021; 158:S32-S36. [PMID: 33707136 DOI: 10.1016/j.jviscsurg.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Management of patients in ambulatory (or short stay) surgery relies on optimal organisation of the health care pathways and specific anesthesiology and surgical protocols. Postoperative medico-surgical complications can occur undetected by traditional hospital surveillance. This article identifies modern digital means that can be adapted to surveillance of patients at home: telephone calls or teleconferences, automatic messaging, mobile phone applications, Web platforms and other e-connected devices. For each, we detail their advantages and their limitations.
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Cittanova ML, Chauvier S, Combettes E, Boccheciampe N, Gerbier V, Leone M, Constantin JM. Association of Automated Text Messaging With Patient Response Rate After Same-Day Surgery. JAMA Netw Open 2021; 4:e2033312. [PMID: 33439262 PMCID: PMC7807290 DOI: 10.1001/jamanetworkopen.2020.33312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This quality improvement study assesses the association of automated text messaging follow-up with the patient response rate after same-day surgery.
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Affiliation(s)
- Marie-Laure Cittanova
- Clinique Saint Jean de Dieu, Department of Anesthesiology, Fondation Cognacq Jay, Paris, France
| | - Sophie Chauvier
- Chauvier Ambulatory unit, Clinique Saint Jean de Dieu, Fondation Cognacq Jay, Paris, France
| | - Evelyne Combettes
- Clinique Saint Jean de Dieu, Department of Anesthesiology, Fondation Cognacq Jay, Paris, France
| | - Nicolas Boccheciampe
- Clinique Saint Jean de Dieu, Department of Anesthesiology, Fondation Cognacq Jay, Paris, France
| | - Vincent Gerbier
- Chauvier Ambulatory unit, Clinique Saint Jean de Dieu, Fondation Cognacq Jay, Paris, France
| | - Marc Leone
- Nord Hospital Department of Anesthesiology and Critical Care, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille Université, Marseille, France
| | - Jean-Michel Constantin
- Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France
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D'Cruz RJ, MacDonald LQ, Zisa N, Zomorrodi A, Murren-Boezem J, Atanda A, Hirschfeld F, Berman L. Institution-initiated text messaging can reduce unplanned emergency department visits after appendectomy. J Pediatr Surg 2021; 56:37-42. [PMID: 33139024 DOI: 10.1016/j.jpedsurg.2020.09.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/22/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND/PURPOSE The purpose of this study was to reduce unplanned Emergency Department (ED) visits for minor complaints in children after appendectomy through proactive institution-driven communication and utilization of telehealth resources. METHODS We developed a text messaging system to initiate communication with parents of postappendectomy patients and connect them with a telehealth visit or a phone call with a surgical provider as needed. Using descriptive statistics, chi square, and statistical process control analytics, we compared rates of postoperative ED visits for the 8 months pre- and post-implementation of the messaging system and summarized the feedback we received from patients. RESULTS A total of 791 laparoscopic appendectomies were performed in two institutions (preintervention = 382, post-intervention = 409). The postoperative ED visit rate decreased from 5.8% preimplementation to 2.4% post-implementation (p = 0.02). Over one-fifth of families messaged (21.6%) had questions in the postoperative period. The majority expressed interest in a video visit (52.5%), while some preferred to speak with the surgeon's office (25%). Over 90% of respondents found the system helpful, and 4.9% opted out. CONCLUSION Implementation of a hospital-initiated text messaging system has the potential to reduce ED visits in the immediate postoperative period after appendectomy. This system can be scaled to include different surgeries across multiple disciplines. LEVEL OF EVIDENCE III. TYPE OF STUDY Clinical Retrospective Pre/Post Intervention Study.
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Affiliation(s)
- Roshan J D'Cruz
- Dept. of Pediatric General Surgery, Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, USA 19803.
| | - Lisa-Qiao MacDonald
- Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 111 S 11th St Philadelphia, PA, USA 19107
| | - Natalina Zisa
- Nemours Children's Hospital, 13535 Nemours Pkwy, Orlando, FL 32827
| | - Arezoo Zomorrodi
- Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, USA 19803
| | | | - Alfred Atanda
- Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, USA 19803
| | - Fiona Hirschfeld
- Nemours Center for Health Delivery Innovation, Wilmington, Delaware, USA 19803
| | - Loren Berman
- Dept. of Pediatric General Surgery, Nemours Alfred I. duPont Hospital for Children, 1600 Rockland Rd, Wilmington, DE, USA 19803; Sidney Kimmel Medical College at Thomas Jefferson University Hospital, 111 S 11th St Philadelphia, PA, USA 19107
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Short message service as a tool to improve perioperative follow-up of surgical outpatients: A before-after study. Anaesth Crit Care Pain Med 2020; 39:799-805. [PMID: 33059106 DOI: 10.1016/j.accpm.2020.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND In outpatient surgery, the patients may be called by phone for detecting and managing perioperative problems. However, phone calls consume time and can waste caregiver's time when the patient is not available. Information and communication technologies could bridge the gap between available resources and need to contact patients. METHODS In the present before-after study, the before-implementation group was contacted by phone (phone group). The after group was contacted with a SMS or a phone call according to patient's preference (SMS group). The primary outcome was the non-inferiority of the SMS system on the occurrence of preoperative events disturbing the organisation of unit including cancellation of the case related to patient's condition the day before and the day of surgery; non-compliance with fasting rules or requirement of an escort; non-adherence to instructions regarding medication; not reporting to the surgical centre, or a delayed arrival > 30 min. RESULTS Among 1300 included outpatients (650 per group), 381 (59%) and 542 (83%) patients were successfully contacted in the preoperative period in phone or SMS group, respectively P < 0.0001). Preoperative events were observed in 94 patients of the phone group (14.5% [CI 95% 11.9-17.3]) and in 77 patients of the SMS group (11.8% [CI 95% 9.5-14.6]), meaning that the upper bound 95% CI of the group was within the non-inferiority margin. CONCLUSIONS In outpatient surgery, implementation of an SMS-based system, supplemented by phone calls for contacting patients is not inferior to a phone-based system in regard to preoperative events.
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Peuchot J, Allard E, Dureuil B, Veber B, Compère V. Efficiency of Text Message Contact on Medical Safety in Outpatient Surgery: Retrospective Study. JMIR Mhealth Uhealth 2020; 8:e14346. [PMID: 32909948 PMCID: PMC7516679 DOI: 10.2196/14346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/24/2019] [Accepted: 05/14/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Establishing pre- and postoperative contact with patients is part of successful medical management in outpatient surgery. In France, this is mostly done via telephone. Automated information with short message service (SMS) reminders might be an interesting alternative to increase the rate of compliance with preoperative instructions, but no study has shown the safety of this approach. OBJECTIVE The objective of this study was to evaluate the impact of pre- and postoperative automated information with SMS reminders on medical safety in outpatient surgery. METHODS We conducted a retrospective, single-center, nonrandomized, controlled study with a before-after design. All adult patients who had outpatient surgery between September 2016 and December 2017 in our university hospital center were included. Before April 2017, patients were contacted by telephone by an outpatient surgery nurse. After April 2017, patients were contacted by SMS reminder. All patients were contacted the day before and the day after surgery. Patients contacted by SMS reminder were also contacted on day 7 after surgery. The primary end point was the conversion rate to full-time hospitalization. Secondary end points were hospitalization causes (anesthetic, surgical, organizational) and hospitalization costs. RESULTS A total of 4388 patients were included, 2160 before and 2228 after the introduction of SMS reminders. The conversion rate to full-time hospitalization was 34/4388 (0.77%) with a difference between SMS group (8/2228, 0.36%) and telephone group (26/2160, 1.20%). The cost of SMS reminders was estimated as half that of telephone calls. CONCLUSIONS In this work, we report a decrease in the rate of conversion to full-time hospitalization with the use of pre- and postoperative SMS reminders. This new approach could represent a safe and cost-effective method in an outpatient surgery setting.
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Affiliation(s)
- Jeremy Peuchot
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | | | - Bertrand Dureuil
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Benoit Veber
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France
| | - Vincent Compère
- Department of Anesthesiology and Critical Care, Rouen University Hospital, Rouen, France.,Day Surgery Unit, Rouen University Hospital, France.,Normandie University, Institut National de la Santé et de la Recherche Médicale Unité 982, Rouen, France
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Kichloo A, Albosta M, Dettloff K, Wani F, El-Amir Z, Singh J, Aljadah M, Chakinala RC, Kanugula AK, Solanki S, Chugh S. Telemedicine, the current COVID-19 pandemic and the future: a narrative review and perspectives moving forward in the USA. Fam Med Community Health 2020; 8:fmch-2020-000530. [PMID: 32816942 PMCID: PMC7437610 DOI: 10.1136/fmch-2020-000530] [Citation(s) in RCA: 286] [Impact Index Per Article: 71.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A narrative review was conducted to examine the current state of the utilisation of telemedicine amid the current COVID-19 pandemic and to evaluate the benefits of continuing telemedicine usage in the future. A literature review was performed for articles related to telemedicine. Databases including PubMed, Google Scholar, Cochrane Library and Ovid MEDLINE were searched. Three reviewers independently performed article selection based on relevance to our topic. We included all articles between 1990 and 2020 related to telemedicine using the following keywords: ‘telemedicine’, ‘telehealth’, ‘policy’, ‘COVID-19’, ‘regulation’, ‘rural’, ‘physical examination’, ‘future’. A total of 60 articles were identified, and through careful selection we narrowed the final number of articles to 42 based on relevance to our topic. Telemedicine has been rapidly evolving over the past several decades. Issues with regulation and reimbursement have prevented its full immersion into the healthcare system. During the current pandemic, Centers for Medicare and Medicaid services have expanded access to telemedicine services. The advantages of telemedicine moving forward include its cost-effectiveness, ability to extend access to specialty services and its potential to help mitigate the looming physician shortage. Disadvantages include lack of available technological resources in certain parts of the country, issues with security of patient data, and challenges in performing the traditional patient examination. It is critically important that changes are made to fully immerse telemedicine services into the healthcare landscape in order to be prepared for future pandemics as well as to reap the benefits of this service in the future.
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Affiliation(s)
- Asim Kichloo
- Internal Medicine, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
| | - Michael Albosta
- Internal Medicine, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
| | - Kirk Dettloff
- Internal Medicine, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
| | - Farah Wani
- Family Medicine, Samaritan Medical Center, Watertown, New York, USA
| | - Zain El-Amir
- Internal Medicine, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
| | - Jagmeet Singh
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Michael Aljadah
- Internal Medicine, Central Michigan University College of Medicine East Campus, Saginaw, Michigan, USA
| | | | | | - Shantanu Solanki
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | - Savneek Chugh
- Nephrology, Westchester Medical Center, Valhalla, New York, USA
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28
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Raimondi D, Azuar P, Barranger E, Azuar AS. [Surgical management of breast cancer in outpatient versus overnight hospitalization: Satisfaction study]. ACTA ACUST UNITED AC 2020; 48:359-365. [PMID: 32027967 DOI: 10.1016/j.gofs.2020.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Breast cancer is the primary female cancer. In cancerology, it is essential to give to the patient some support. The advent of outpatient surgery optimizes the care path. This need for support of patients raises the question of its compatibility with the day surgery. The purpose is to compare the satisfaction of outpatients with those who stay overnight after surgery of breast cancer. MéTHODS: Patients who underwent breast conservative surgery were included. It is a mixed study, a quantitative, observational and prospective one using a satisfaction survey and a qualitative one which consisted on semi - directive individual interviews. We compared the satisfaction rate (highest marks). RESULTS There were 91 patientes, 38 in the ambulatory group and 53 in the overnight group. There was no significant difference in satisfaction between the two groups (P=0.18). The difficulties frequently highlighted by the patients during their stay were the organizational management, the lack of hospital comfort and the sometimes long wait. The need for human support was unanimous. CONCLUSION The satisfaction was excellent in the study. The mode of hospitalization does not seem to play a role here on satisfaction. This hospitalization mode can only be envisaged by providing sufficient human and technical resources. Enhanced recovery after surgery appears to be an alternative to outpatient surgery.
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Affiliation(s)
- D Raimondi
- Service de gynécologie-obstétrique, Hôpital l'Archet-II, CHU de Nice, 151, route de Saint-Antoine, 06200 Nice, France.
| | - P Azuar
- Centre hospitalier Clavary, 28, chemin de Clavary, 06130 Grasse, France
| | - E Barranger
- Direction générale, Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France
| | - A-S Azuar
- Centre hospitalier Clavary, 28, chemin de Clavary, 06130 Grasse, France
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29
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Grass F, Hübner M, Mathis KL, Hahnloser D, Dozois EJ, Kelley SR, Demartines N, Larson DW. Identification of patients eligible for discharge within 48 h of colorectal resection. Br J Surg 2020; 107:546-551. [PMID: 31912500 DOI: 10.1002/bjs.11399] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study aimed to identify patients eligible for a 48-h stay after colorectal resection, to provide guidance for early discharge planning. METHODS A bi-institutional retrospective cohort study was undertaken of consecutive patients undergoing major elective colorectal resection for benign or malignant pathology within a comprehensive enhanced recovery pathway between 2011 and 2017. Overall and severe (Clavien-Dindo grade IIIb or above) postoperative complication and readmission rates were compared between patients who were discharged within 48 h and those who had hospital stay of 48 h or more. Multinominal logistic regression analysis was performed to ascertain significant factors associated with a short hospital stay (less than 48 h). RESULTS In total, 686 of 5122 patients (13·4 per cent) were discharged within 48 h. Independent factors favouring a short hospital stay were age below 60 years (odds ratio (OR) 1·34; P = 0·002), ASA grade less than III (OR 1·42; P = 0·003), restrictive fluid management (less than 3000 ml on day of surgery: OR 1·46; P < 0·001), duration of surgery less than 180 min (OR 1·89; P < 0·001), minimally invasive approach (OR 1·92; P < 0·001) and wound contamination grade below III (OR 4·50; P < 0·001), whereas cancer diagnosis (OR 0·55; P < 0·001) and malnutrition (BMI below 18 kg/m2 : OR 0·42; P = 0·008) decreased the likelihood of early discharge. Patients with a 48-h stay had fewer overall (10·8 per cent versus 30·6 per cent in those with a longer stay; P < 0·001) and fewer severe (2·6 versus 10·2 per cent respectively; P < 0·001) complications, and a lower readmission rate (9·0 versus 11·8 per cent; P = 0·035). CONCLUSION Early discharge of selected patients is safe and does not increase postoperative morbidity or readmission rates. In these patients, outpatient colorectal surgery should be feasible on a large scale with logistical optimization.
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Affiliation(s)
- F Grass
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - M Hübner
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - K L Mathis
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - D Hahnloser
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - E J Dozois
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - S R Kelley
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - N Demartines
- Department of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - D W Larson
- Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota, USA
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Goz V, Spiker WR, Brodke D. Mobile messaging and smartphone apps for patient communication and engagement in spine surgery. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:S163. [PMID: 31624729 DOI: 10.21037/atm.2019.08.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Mobile health (mHealth) applications are rapidly becoming increasingly available to patients. These interventions utilize simple mobile messaging (SMS) and software applications on mobile devices for a variety of purposes. In the surgical population mHealth applications have shown promise in increasing medication and protocol adherence, monitoring patients after surgery, and helping modify behaviors associated with poor surgical outcomes. There is a paucity of spine specific applications at this time. Further development and study of efficacy of spine specific mHealth applications is needed.
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Affiliation(s)
- Vadim Goz
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | | | - Darrel Brodke
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
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31
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Leconte D, Beloeil H, Dreano T, Ecoffey C. Post Ambulatory Discharge Follow-up Using Automated Text Messaging. J Med Syst 2019; 43:217. [PMID: 31172292 DOI: 10.1007/s10916-019-1278-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022]
Abstract
Ambulatory surgery has grown to be the most common procedure in developed countries. Efficient quality of care and safety often require calling patient at day one after outpatient surgery to check patient's recovery and search for complications. This increasing flow in same day surgery centres motivates the use of automatic systems to contact patients. The overall objective of this study was to evaluate automated software sending text messages (TM) to patients at day 1 after ambulatory surgery compared to classical phone calls. This prospective study took place in Rennes Teaching Hospital, France, from June 1st, 2015 to December 15th, 2016. All patients owning a mobile phone were included, adults and children by means of their parents. The primary end point was the rate of successfully contacted patients, compared to usual phone calls in 2014. In cases of no response or an abnormal response, an automatic alert was sent to the ambulatory unit. Within the 7246 patients included, response rate to TM was significantly higher than response to phone calls in 2014 (87% vs 57%, respectively p < 0.0001). Most patients (85%) responded in less than 60 min. The TM algorithm detected 36% alerts (12% for lack of response to TM and 24% for TM's content). The total of reached patients' rate with TM and then phone call after an alert was 90%. Post ambulatory discharge follow-up using automated TM was successfully and easily experienced as more patients were contacted.
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Affiliation(s)
- David Leconte
- Université Rennes, CHU Rennes, Pôle Anesthésie-Samu-Urgences-Réanimations, F-35033, Rennes, France
| | - Hélène Beloeil
- Université Rennes, INSERM, INRA, CIC 1414, Numecan, CHU Rennes, Pôle Anesthésie-Samu-Urgences-Réanimations, 2 Rue Henri Le Guilloux, 35033, Rennes Cedex 9, France.
| | - Thierry Dreano
- CHU Rennes, Service d'orthopédie et de traumatologie, F-35033, Rennes, France
| | - Claude Ecoffey
- Université Rennes, CHU Rennes, CIC 1414, Pôle Anesthésie-Samu-Urgences-Réanimations, F-35033, Rennes, France
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32
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Borsuk DJ, Al-Khamis A, Geiser AJ, Zhou D, Warner C, Kochar K, Marecik SJ. S128: Active post discharge surveillance program as a part of Enhanced Recovery After Surgery protocol decreases emergency department visits and readmissions in colorectal patients. Surg Endosc 2019; 33:3816-3827. [PMID: 30859488 DOI: 10.1007/s00464-019-06725-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 03/01/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Enhanced Recovery After Surgery (ERAS) programs aim to standardize perioperative care to reduce morbidity and cost. Our study examined an Active Post-Discharge Surveillance (APDS) program in reducing avoidable readmissions and emergency department (ED) visits in postoperative colorectal ERAS patients. METHODS Colectomy (right, subtotal and total) and low anterior resection cases performed at a tertiary care hospital between 2015 and 2018 were reviewed. ED visits, 30-day readmissions, and patients' APDS participation were assessed. Our APDS followed a modern text messaging paradigm offered to all patients free-of-charge. RESULTS Of 236 patients that underwent colectomy, 123 utilized APDS and 113 did not. Overall, both non-surveillance (NS) and active surveillance (AS) groups had similar preoperative characteristics. Length of hospital stay at index surgery was longer in the NS compared to AS group, 4.7 ± 2.6 vs. 2.6 ± 2.8 days, respectively (p < 0.001). In the NS group, 16 patients visited the ED, of which 14 (14/16, 87.5%) were ultimately readmitted. One patient was directly readmitted from the surgeon's office, resulting in a total of 15 (15/113, 13.3%) total patients readmitted by postoperative day (POD) 30. In the AS group, 9 patients visited the ED, of which 7 (7/9, 77.8%) were ultimately readmitted. One patient was directly readmitted, resulting in a total of 8 (8/123, 6.5%) total patients readmitted by POD 30. AS patients had significantly lower odds of visiting the ED when compared to NS patients (OR: 0.356; 95% CI: 0.138-0.919; p = 0.0328). Similarly, AS patients had significantly lower odds of readmission when compared to NS patients (OR: 0.343; 95% CI: 0.132-0.892; p = 0.0283). CONCLUSIONS APDS allows many postoperative issues to be resolved in outpatient settings without ER visits or readmission. This indicates APDS is a valuable ERAS adjunct by establishing a cost-effective and convenient communication line between patients and their surgical team.
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Affiliation(s)
- Daniel J Borsuk
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA. .,Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Ahmed Al-Khamis
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA
| | - Andrew J Geiser
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA
| | - Dimin Zhou
- Chicago Medical School, North Chicago, IL, USA
| | - Christina Warner
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA
| | - Kunal Kochar
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA
| | - Slawomir J Marecik
- Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, 1550 N. Northwest Highway, Suite 107, Park Ridge, 60068, IL, USA.,University of Illinois College of Medicine, Chicago, IL, USA
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Goldenthal SB, Portney D, Steppe E, Ghani K, Ellimoottil C. Assessing the feasibility of a chatbot after ureteroscopy. Mhealth 2019; 5:8. [PMID: 31019961 PMCID: PMC6458345 DOI: 10.21037/mhealth.2019.03.01] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 02/28/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Patients experience common symptoms and/or complications after undergoing ureteroscopy, which is a common procedure used to treat kidney stones. Current methods for patient education regarding these complications include counseling and discharge materials. This study aimed to assess chatbot usage and their ability to deliver information to patient post-ureteroscopy. METHODS Patients who underwent ureteroscopy at the University of Michigan were given instructions to activate the chatbot. Within one to four weeks of their surgery, semi-structured interviews were conducted regarding post-surgical recovery and chatbot usage. RESULTS Twenty patients were interviewed, seven of whom activated the chatbot. Frequent reasons for not activating the chatbot included misplacing instructions for chatbot use (n=6), relying on follow-up with clinic or discharge materials (n=4), inability to activate chatbot (n=2), and inability to text (n=1). Perceived benefits included alleviation of concerns surrounding common symptoms and quick access to information for non-emergent issues. CONCLUSIONS These results suggest that chatbots are a convenient method to address common concerns post-ureteroscopy. However, better integration in the flow of care delivery and improved usability are needed to increase patient engagement.
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Affiliation(s)
- Steven B. Goldenthal
- Institute of Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor, MI, USA
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - David Portney
- Institute of Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor, MI, USA
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Emma Steppe
- Institute of Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor, MI, USA
| | - Khurshid Ghani
- Institute of Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor, MI, USA
| | - Chad Ellimoottil
- Institute of Healthcare Policy and Innovation, University of Michigan Health System, Ann Arbor, MI, USA
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Ambulatory colectomy: fast-track management pushed to its limits? Tech Coloproctol 2018; 22:741-742. [DOI: 10.1007/s10151-018-1871-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/19/2018] [Indexed: 12/01/2022]
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Garnier F, Sciard D, Marchand-Maillet F, Theissen A, Mohamed D, Alberti C, Beaussier M. Clinical Interest and Economic Impact of Preoperative SMS Reminders before Ambulatory Surgery: A Propensity Score Analysis. J Med Syst 2018; 42:150. [PMID: 29968118 DOI: 10.1007/s10916-018-1000-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 06/21/2018] [Indexed: 10/28/2022]
Abstract
Patient contact by telephone the day before ambulatory surgery is considered as a best practice. The Short Message Service (SMS) could be a suitable alternative. The objective of this prospective study was to evaluate the interest of preoperative instruction (PI) reminders by SMS compared to telephone calls. This was a prospective single center before-and-after study. Patients scheduled in ambulatory surgery were included during 2 consecutive periods of 10 weeks. The "Call" group received a telephone call for preoperative instructions (PI) and the "SMS" group received an automated protocol SMS reminder. The primary endpoint was patient compliance with PI and time of convocation. The two populations were compared with a non-inferiority hypothesis and the impact of the contact modality on compliance with the PI was assessed using a propensity score. The analysis concerned 301 patients in the Call group and 298 in the SMS group. The absence of dysfunction was observed in 75% of patients in the SMS group compared with 61% in the Call group (Risk difference: 14% [95%CI: 7-21]). The use of SMS was associated with a significant improvement in compliance with the PI (Odds ratio: 1.90 [1.48-2.42]; p < 0.0001). Patient satisfaction was similar regardless of the method of PI reminders. The automation of preoperative SMS reminders is associated with a better respect of the PI compared to the conventional calling method. This PI reminder method satisfies the majority of patients and may have a favorable financial impact.
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Affiliation(s)
- Fanny Garnier
- Department of Anesthesiology and Intensive Care Medicine and the Ambulatory Surgery Unit, St-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, UPMC Univ, Paris 6, France
| | - Didier Sciard
- Ambulatory Surgical Unit and Department of Anesthesiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - Florence Marchand-Maillet
- Department of Anesthesiology and Intensive Care Medicine and the Ambulatory Surgery Unit, St-Antoine University Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne Universités, UPMC Univ, Paris 6, France
| | - Alexandre Theissen
- Department of Anesthesiology and Ambulatory Care Center, Princess Grace Hospital, Pasteur Avenue, Monaco Principality, Monaco
| | - Damir Mohamed
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, University Paris Diderot, Sorbonne Paris-Cité, CIC-EC 1426 and, UMR-S 1123 ECEVE, 75019, Paris, France
| | - Corinne Alberti
- Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, CHU Robert Debré, University Paris Diderot, Sorbonne Paris-Cité, CIC-EC 1426 and, UMR-S 1123 ECEVE, 75019, Paris, France
| | - Marc Beaussier
- Ambulatory Surgical Unit and Department of Anesthesiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
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Lu K, Marino NE, Russell D, Singareddy A, Zhang D, Hardi A, Kaar S, Puri V. Use of Short Message Service and Smartphone Applications in the Management of Surgical Patients: A Systematic Review. Telemed J E Health 2018; 24:406-414. [DOI: 10.1089/tmj.2017.0123] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Keyin Lu
- Saint Louis University School of Medicine, St. Louis, Missouri
- Epharmix Research Center, St. Louis, Missouri
| | - Nikolas E. Marino
- Saint Louis University School of Medicine, St. Louis, Missouri
- Epharmix Research Center, St. Louis, Missouri
| | - David Russell
- Saint Louis University School of Medicine, St. Louis, Missouri
- Epharmix Research Center, St. Louis, Missouri
| | - Aashray Singareddy
- Saint Louis University School of Medicine, St. Louis, Missouri
- Epharmix Research Center, St. Louis, Missouri
| | - Donald Zhang
- Saint Louis University School of Medicine, St. Louis, Missouri
- Epharmix Research Center, St. Louis, Missouri
| | - Angela Hardi
- Becker Medical Library, Washington University in Saint Louis School of Medicine, St. Louis, Missouri
| | - Scott Kaar
- Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, Missouri
| | - Varun Puri
- Division of Cardiothoracic Surgery, Washington University in Saint Louis School of Medicine, St. Louis, Missouri
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Williams AM, Bhatti UF, Alam HB, Nikolian VC. The role of telemedicine in postoperative care. Mhealth 2018; 4:11. [PMID: 29963556 PMCID: PMC5994447 DOI: 10.21037/mhealth.2018.04.03] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/11/2018] [Indexed: 12/15/2022] Open
Abstract
Telemedicine has become one of the most rapidly-expanding components of the health care system. Its adoption has afforded improved access to care, greater resource efficiency, and decreased costs associated with traditional office visits and has been well established in a wide array of fields. Telemedicine has been adopted in several domains of surgical care. In recent years, the role of telemedicine in postoperative care has caught attention as it has demonstrated excellent clinical outcomes, enhanced patient satisfaction, increased accessibility along with reduced wait times, and cost savings for patients and health care systems. In this narrative review, we describe the history of telemedicine, its adoption in the field of surgery and its various modalities, its use in the postoperative setting, and the potential benefits to both patients and healthcare systems. As telemedicine continues to emerge as a powerful tool for health care delivery, we also discuss several barriers to its widespread adoption as well as the future utility of telemedicine in postoperative care.
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Affiliation(s)
- Aaron M Williams
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Umar F Bhatti
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Hasan B Alam
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
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Abstract
Enhanced recovery after surgery (ERAS) aims at reducing the length of hospital stays and complications. Everyone has a role to play - healthcare professionals, medical secretaries, administrative staff and patients. A coordinated treatment pathway must be ensured and changes in practices must be accepted.
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Affiliation(s)
- Olivier Raspado
- Infirmerie Protestante, 1-3 chemin du Penthod, 69300 Caluire et Cuire, France.
| | - Brigitte Crispin
- Unité de chirurgie colorectale, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Bruxelles, Belgique
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