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Eshghi F, Pourgholam N, Kianian T, Kashani M, Azami M. Innovative services in home health nursing: a scoping review protocol. BMJ Open 2024; 14:e077174. [PMID: 38531577 PMCID: PMC10966785 DOI: 10.1136/bmjopen-2023-077174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
INTRODUCTION Advances in the use of technology in home health nursing (HHN) not only can facilitate the delivery of home care but can also influence the entire healthcare system. Additionally, it can contribute to the individual autonomy in the area of health. The aim of this scoping review protocol is to identify, describe and map the types of innovative services and their delivery approaches in the HHN structure worldwide. METHODS AND ANALYSIS The main question of the research is as follows: what are different types of innovative services and their delivery approaches in the HHN structure around the world? The Joanna Briggs Institute (JBI) method for scoping reviews will guide the conducting this scoping review, and the participants, concept and context framework will be used as eligibility criteria. MEDLINE databases via PubMed, Embase, Cochrane Library, Scopus, Web of Science, Science Direct, Persian scientific databases and grey literature will be searched prior to May 2024 to include eligible studies, without any language restrictions. To be included, studies will be reviewed by two independent reviewers. A data extraction form developed for the study purpose will be used to extract the data relevant to the review questions. Data analysis will be performed based on each innovative service and answering the subquestions about it. According to the concepts of interest, the results will be analysed and presented using tables, figures, images and a narrative summary. ETHICS AND DISSEMINATION This study will not involve human or animal participants. Data will be sourced from the published literature. To be published, the results of the study will be submitted to an international peer-reviewed, open-access journal as well as scientific meetings on HHN and innovative services research.
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Affiliation(s)
- Fateme Eshghi
- Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Nima Pourgholam
- Nursing and Midwifery Care Research Center, Department of Medical Surgical Nursing, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Toktam Kianian
- Nursing and Midwifery Care Research Center, Department of Community Health and Geriatric Nursing, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Maryam Kashani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Masoomeh Azami
- Shahid Beheshti University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
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Baniasadi T, Hassaniazad M, Rostam Niakan Kalhori S, Shahi M, Ghazisaeedi M. Developing a mobile health application for wound telemonitoring: a pilot study on abdominal surgeries post-discharge care. BMC Med Inform Decis Mak 2023; 23:103. [PMID: 37268995 DOI: 10.1186/s12911-023-02199-z] [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: 02/25/2022] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Many early signs of Surgical Site Infection (SSI) developed during the first thirty days after discharge remain inadequately recognized by patients. Hence, it is important to use interactive technologies for patient support in these times. It helps to diminish unnecessary exposure and in-person outpatient visits. Therefore, this study aims to develop a follow-up system for remote monitoring of SSIs in abdominal surgeries. MATERIAL AND METHODS This pilot study was carried out in two phases including development and pilot test of the system. First, the main requirements of the system were extracted through a literature review and exploration of the specific needs of abdominal surgery patients in the post-discharge period. Next extracted data was validated according to the agreement level of 30 clinical experts by the Delphi method. After confirming the conceptual model and the primary prototype, the system was designed. In the pilot test phase, the usability of the system was qualitatively and quantitatively evaluated by the participation of patients and clinicians. RESULTS The general architecture of the system consists of a mobile application as a patient portal and a web-based platform for patient remote monitoring and 30-day follow-up by the healthcare provider. Application has a wide range of functionalities including collecting surgery-related documents, and regular assessment of self-reported symptoms via systematic tele-visits based on predetermined indexes and wound images. The risk-based models embedded in the database included a minimum set with 13 rules derived from the incidence, frequency, and severity of SSI-related symptoms. Accordingly, alerts were generated and displayed via notifications and flagged items on clinicians' dashboards. In the pilot test phase, out of five scheduled tele-visits, 11 (of 13) patients (85%), completed at least two visits. The nurse-centered support was very helpful in the recovery stage. Finally, the result of a pilot usability evaluation showed users' satisfaction and willingness to use the system. CONCLUSION Implementing a telemonitoring system is potentially feasible and acceptable. Applying this system as part of routine postoperative care management can provide positive effects and outcomes, especially in the era of coronavirus disease when more willingness to telecare service is considered.
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Affiliation(s)
- Tayebeh Baniasadi
- Department of Health Information Technology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sharareh Rostam Niakan Kalhori
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Braunschweig, Germany
| | - Mehraban Shahi
- Department of Health Information Technology, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran.
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Bitkina OV, Park J, Kim HK. Application of artificial intelligence in medical technologies: A systematic review of main trends. Digit Health 2023; 9:20552076231189331. [PMID: 37485326 PMCID: PMC10359663 DOI: 10.1177/20552076231189331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/30/2023] [Indexed: 07/25/2023] Open
Abstract
Objective Artificial intelligence (AI) has been increasingly applied in various fields of science and technology. In line with the current research, medicine involves an increasing number of artificial intelligence technologies. The introduction of rapid AI can lead to positive and negative effects. This is a multilateral analytical literature review aimed at identifying the main branches and trends in the use of using artificial intelligence in medical technologies. Methods The total number of literature sources reviewed is n = 89, and they are analyzed based on the literature reporting evidence-based guideline PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for a systematic review. Results As a result, from the initially selected 198 references, 155 references were obtained from the databases and the remaining 43 sources were found on open internet as direct links to publications. Finally, 89 literature sources were evaluated after exclusion of unsuitable references based on the duplicated and generalized information without focusing on the users. Conclusions This article is identifying the current state of artificial intelligence in medicine and prospects for future use. The findings of this review will be useful for healthcare and AI professionals for improving the circulation and use of medical AI from design to implementation stage.
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Affiliation(s)
- Olga Vl Bitkina
- Department of Industrial and Management Engineering, Incheon National University, Incheon, Korea
| | - Jaehyun Park
- Department of Industrial and Management Engineering, Incheon National University, Incheon, Korea
| | - Hyun K. Kim
- School of Information Convergence, Kwangwoon University, Seoul, Korea
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Meur NL, Padilla C, Ghoroubi N, Lamirault G, Chatellier G, Gouëffic Y. Geographical disparities of endovascular revascularisations in ambulatory setting in France from 2015 to 2019. Eur J Vasc Endovasc Surg 2022; 63:890-897. [DOI: 10.1016/j.ejvs.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/11/2022] [Accepted: 03/20/2022] [Indexed: 11/29/2022]
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Ben-Ali W, Lamarche Y, Carrier M, Demers P, Bouchard D, El-Hamamsy I, Cartier R, Pellerin M, Perrault LP. Use of Mobile-Based Application for Collection of Patient-Reported Outcomes in Cardiac Surgery. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2021; 16:536-544. [PMID: 34882492 DOI: 10.1177/15569845211045677] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Application-based (app) technology has been studied for patient engagement and collecting patient-reported outcomes (PROs) in several surgical specialties with limited research in cardiac surgery. The aim of study was to determine the effectiveness of app-based technology for collecting PROs, improving the patient experience, and reducing health services utilization in a cardiac surgery center. METHODS Patients accessed an interactive app via smartphones. Patients were guided from 4 weeks preoperative to 4 weeks postoperative via reminders, tasks, PRO surveys, and evidence-based education. In the postoperative period, patients were engaged with daily health surveys to track warning signs and recovery milestones. Based on the patient's signs and symptoms, the app escalated lower risk issues to self-care education or higher risk issues to the care team (e.g., phone call to a nurse). RESULTS Sixty-six percent of patients (730 of 1,108) activated their app account. Two hundred seventy-seven patients completed an end-of-program feedback survey, with 94% of patients recommending the app and 98% of patients finding the app was helpful in recovery. Patients also reported using the app to avoid unnecessary health services utilization, with 45% of patients using the app to avoid at least 1 phone call and 28% of patients using the app to avoid at least 1 hospital visit. CONCLUSIONS App-based technology for patient engagement is an effective modality to enhance the patient experience, better understand the trajectory of recovery, and reduce unnecessary health services utilization in cardiac surgery.
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Affiliation(s)
- Walid Ben-Ali
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Yoan Lamarche
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Michel Carrier
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Philippe Demers
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Denis Bouchard
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Ismail El-Hamamsy
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Raymond Cartier
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Michel Pellerin
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
| | - Louis P Perrault
- Department of Cardiac Surgery, 25465Montreal Heart Institute, Canada
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Coppens M, Van Caelenberg E, De Regge M. Postoperative innovative technology for ambulatory anesthesia and surgery. Curr Opin Anaesthesiol 2021; 34:709-713. [PMID: 34269739 DOI: 10.1097/aco.0000000000001036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To give an overview of the impact of different forms of telehealth that are currently used in ambulatory anesthesia and surgery. Telehealth is applicable during the early recovery and intermediate recovery period (e.g. monitoring of quality of recovery), and as a tool for postoperative check-up during the late recovery phase. RECENT FINDINGS Postoperative follow-up after ambulatory surgery is still crucial to maintain quality of care as pain and postoperative nausea and vomiting remain common adverse events. There is a surge of telehealth applications from procedure-specific commercial smartphone apps (mHealth) to complete digital patient platforms instituted by the government. However, patient and healthcare provider engagement is not universal. Usability of these applications is mandatory as well as identifying and overcoming the barriers to its use. SUMMARY Telehealth gives many opportunities for postoperative follow-up of ambulatory surgery patients. Clear evidence on the benefits of telehealth in ambulatory surgery is however still sparse. Future research should focus on telehealth for improving quality and safety of postoperative recovery, convincing policymakers for reimbursement encouraging healthcare providers and patients to engage in telehealth.
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Affiliation(s)
- Marc Coppens
- Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, Ghent University
| | - Els Van Caelenberg
- University Hospital Ghent, Department of Anesthesia and Perioperative Medicine, Ambulatory Surgery Unit
| | - Melissa De Regge
- Faculty of Economics and Business Administration, Department of Marketing, Innovation and Organinsation, Ghent University and Strategic Policy Cel, Ghent University Hospital, Ghent, Belgium
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Dawes AJ, Lin AY, Varghese C, Russell MM, Lin AY. Mobile health technology for remote home monitoring after surgery: a meta-analysis. Br J Surg 2021; 108:1304-1314. [PMID: 34661649 DOI: 10.1093/bjs/znab323] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 08/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Mobile health (mHealth) technology has been proposed as a method of improving post-discharge surveillance. Little is known about how mHealth has been used to track patients after surgery and whether its use is associated with differences in postoperative recovery. METHODS Three databases (PubMed, MEDLINE and the Cochrane Central Registry of Controlled Trials) were searched to identify studies published between January 1999 and February 2021. Mobile health was defined as any smartphone or tablet computer capable of electronically capturing health-related patient information and transmitting these data to the clinical team. Comparable outcomes were pooled via meta-analysis with additional studies compiled via narrative review. The quality of each study was assessed based on Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS Forty-five articles met inclusion criteria. While the majority of devices were designed to capture general health information, others were specifically adapted to the expected outcomes or potential complications of the index procedure. Exposure to mHealth was associated with fewer emergency department visits (odds ratio 0.42, 95 per cent c.i. 0.23 to 0.79) and readmissions (odds ratio 0.47, 95 per cent c.i. 0.29 to 0.77) as well as accelerated improvements in quality of life after surgery. There were limited data on other postoperative outcomes. CONCLUSION Remote home monitoring via mHealth is feasible, adaptable, and may even promote more effective postoperative care. Given the rapid expansion of mHealth, physicians and policymakers need to understand these technologies better so that they can be integrated into high-quality clinical care.
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Affiliation(s)
- A J Dawes
- Section of Colon and Rectal Surgery, Division of General Surgery, Stanford University School of Medicine, Stanford, California, USA.,Stanford-Surgery Policy Improvement Research & Education Center, Stanford University School of Medicine, Stanford, California, USA
| | - A Y Lin
- Department of Surgery, Wellington Regional Hospital, Wellington, New Zealand.,Department of Surgery and Anaesthesia (Wellington), University of Otago, New Zealand
| | - C Varghese
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - M M Russell
- Section of Colon and Rectal Surgery, Division of General Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.,VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - A Y Lin
- Section of Colon and Rectal Surgery, Division of General Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Kukafka R, Rong LQ. Mobile Applications in Clinical and Perioperative Care for Anesthesia: Narrative Review. J Med Internet Res 2021; 23:e25115. [PMID: 34533468 PMCID: PMC8486987 DOI: 10.2196/25115] [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: 10/22/2020] [Revised: 12/28/2020] [Accepted: 06/14/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The increasing use of smartphones by providers and patients alike demonstrates that digital health utilizing mobile applications has the potential to transform perioperative care and education in anesthesia. OBJECTIVE This literature review describes the current scope of the use of mobile applications in anesthesiology. METHODS Literature was searched using PubMed, Scopus, and clinicaltrials.gov for articles published from January 1, 2010, through April 1, 2020. Only English language studies were included. Articles were included if they examined the use of a mobile health application in the setting of anesthesia or the perioperative (immediate preoperative, intraoperative, and postoperative) period. Studies were excluded if they explored video interventions or did not examine the feasibility or efficacy of the mobile app. RESULTS We included 29 articles, and three areas of clinical functionality were identified: patient-centered care (preoperative, intraoperative, and postoperative), systems-based improvement, and medical education. Several studies demonstrate the feasibility and reliability of mobile apps in these areas, but many are only tested for efficacy in simulated environments or with small patient samples. CONCLUSIONS Mobile health applications show promise in improving communication between anesthesiologists, improving workflow efficiency, enhancing medical education, and reducing hospital costs. However, there is a need for validation and improvement before full implementation by the provider, patients, and hospital systems. Future studies are needed to demonstrate meaningful health outcomes to create guidelines and recommendations specific to the application of mobile technology to health care.
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Affiliation(s)
| | - Lisa Qia Rong
- Department of Anesthesiology, Weill Cornell Medicine - New York-Presbyterian Hospital, New York, NY, United States
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Fischer F, Kleen S. Possibilities, Problems, and Perspectives of Data Collection by Mobile Apps in Longitudinal Epidemiological Studies: Scoping Review. J Med Internet Res 2021; 23:e17691. [PMID: 33480850 PMCID: PMC7864774 DOI: 10.2196/17691] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 11/06/2020] [Accepted: 12/17/2020] [Indexed: 12/16/2022] Open
Abstract
Background The broad availability of smartphones and the number of health apps in app stores have risen in recent years. Health apps have benefits for individuals (eg, the ability to monitor one’s health) as well as for researchers (eg, the ability to collect data in population-based, clinical, and observational studies). Although the number of health apps on the global app market is huge and the associated potential seems to be great, app-based questionnaires for collecting patient-related data have not played an important role in epidemiological studies so far. Objective This study aims to provide an overview of studies that have collected patient data using an app-based approach, with a particular focus on longitudinal studies. This literature review describes the current extent to which smartphones have been used for collecting (patient) data for research purposes, and the potential benefits and challenges associated with this approach. Methods We conducted a scoping review of studies that used data collection via apps. PubMed was used to identify studies describing the use of smartphone app questionnaires for collecting data over time. Overall, 17 articles were included in the summary. Results Based on the results of this scoping review, there are only a few studies that integrate smartphone apps into data-collection approaches. Studies dealing with the collection of health-related data via smartphone apps have mainly been developed with regard to psychosomatic, neurodegenerative, respiratory, and cardiovascular diseases, as well as malign neoplasm. Among the identified studies, the duration of data collection ranged from 4 weeks to 12 months, and the participants’ mean ages ranged from 7 to 69 years.
Potential can be seen for real-time information transfer, fast data synchronization (which saves time and increases effectivity), and the possibility of tracking responses longitudinally. Furthermore, smartphone-based data-collection techniques might prevent biases, such as reminder bias or mistakes occurring during manual data transfers. In chronic diseases, real-time communication with physicians and early detection of symptoms enables rapid modifications in disease management. Conclusions The results indicate that using mobile technologies can help to overcome challenges linked with data collection in epidemiological research. However, further feasibility studies need to be conducted in the near future to test the applicability and acceptance of these mobile apps for epidemiological research in various subpopulations.
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Affiliation(s)
- Florian Fischer
- Institut of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany.,Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Sina Kleen
- Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
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Yan L, Rong F, Gao M, Chen G, Su Y, Xing L, Xu M. Complications and feasibility analysis of ambulatory surgery for gynecological diseases in China. Medicine (Baltimore) 2021; 100:e23995. [PMID: 33429761 PMCID: PMC7793318 DOI: 10.1097/md.0000000000023995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/25/2020] [Indexed: 11/26/2022] Open
Abstract
The Chinese government is attaching great importance to the development of ambulatory surgery in order to optimize the healthcare system in China. The study aims to examine the complications and quality indicators of patients who underwent gynecological ambulatory surgery at a tertiary hospital in China.This was a retrospective study of patients who underwent ambulatory surgery between July and September 2019 at the Department of Gynecology of the First Affiliated Hospital of Shandong First Medical University. The patients were followed by phone at 30 days after discharge. The postoperative complications, mortality, unplanned re-operation, delayed discharge, unplanned re-hospitalization, and patient satisfaction were collected. The patients who underwent conventional hysteroscopic resection of uterine lesions during the same period were collected as controls for the economics analysis.A total of 392 patients who underwent ambulatory gynecological surgery were included. Fifteen patients had postoperative complications, and the total complication rate was 3.8% (15/392). Eight (8/392, 2.0%) patients had delayed discharge. There were no unplanned re-operations and deaths. There were two (2/392, 0.5%) cases of unplanned re-hospitalization. At 30 days after discharge, two patients were dissatisfied, and 390 cases were satisfied, for an overall satisfaction rate of 99.5%. Compared with conventional hysteroscopic resection of uterine lesions, ambulatory hysteroscopic surgery had a shorter hospital stay and lower total costs (P < .05) but similar surgery-related costs.Ambulatory gynecological surgery is feasible in China, with an acceptable complication profile and obvious economic and social benefits. Nevertheless, hospital management shall be reinforced.
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Affiliation(s)
- Li Yan
- Department of Obstetrics and Gynecology
| | | | | | | | | | | | - Min Xu
- Administrative Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
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Ceruti C, Carry PY, Ferrier C, Friggeri A, Piriou V. [Telehealth in peroperative medicine]. ACTA ACUST UNITED AC 2020; 24:243-249. [PMID: 32963474 PMCID: PMC7498471 DOI: 10.1016/j.pratan.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
La télémédecine est en plein essor dans tous les domaines médicaux. En plus d’être l’une des priorités de l’OMS afin de répondre aux problèmes des coûts et de l’accessibilité à des soins de qualité, que ce soit dans les pays développés ou en voie de développement, la crise sanitaire récente liée au COVID-19 a montré qu’elle pouvait être un atout certain pour la permanence des soins en situation de crise. Si la télémédecine en anesthésie se développe pour l’ensemble de la prise en charge péri-opératoire des patients, cette mise au point vise à présenter les données récentes de la littérature concernant la place de la télémédecine en anesthésie pour l’évaluation pré-opératoire. Quatre points principaux sont abordés : (1) l’éligibilité et la faisabilité de la téléconsultation d’anesthésie; (2) son efficacité en terme de temps passé en consultation d’anesthésie, taux d’annulation d’intervention et concordance de l’examen physique; (3) la satisfaction des patients, et enfin; (4) son potentiel impact économique.
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Affiliation(s)
- Charlotte Ceruti
- Service d'anesthésie réanimation, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard-Lyon-1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Pierre Yves Carry
- Service d'anesthésie réanimation, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard-Lyon-1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Clémence Ferrier
- Service d'anesthésie réanimation, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard-Lyon-1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Arnaud Friggeri
- Service d'anesthésie réanimation, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard-Lyon-1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - Vincent Piriou
- Service d'anesthésie réanimation, centre hospitalier Lyon-Sud, hospices civils de Lyon, université Claude-Bernard-Lyon-1, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
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Patel B, Thind A. Usability of Mobile Health Apps for Postoperative Care: Systematic Review. JMIR Perioper Med 2020; 3:e19099. [PMID: 33393925 PMCID: PMC7709840 DOI: 10.2196/19099] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Mobile health (mHealth) apps are increasingly used postoperatively to monitor, educate, and rehabilitate. The usability of mHealth apps is critical to their implementation. OBJECTIVE This systematic review evaluates the (1) methodology of usability analyses, (2) domains of usability being assessed, and (3) results of usability analyses. METHODS The A Measurement Tool to Assess Systematic Reviews checklist was consulted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was adhered to. Screening was undertaken by 2 independent reviewers. All included studies were assessed for risk of bias. Domains of usability were compared with the gold-standard mHealth App Usability Questionnaire (MAUQ). RESULTS A total of 33 of 720 identified studies were included for data extraction. Of the 5 included randomized controlled trials (RCTs), usability was never the primary end point. Methodology of usability analyses included interview (10/33), self-created questionnaire (18/33), and validated questionnaire (9/33). Of the 3 domains of usability proposed in the MAUQ, satisfaction was assessed in 28 of the 33 studies, system information arrangement was assessed in 11 of the 33 studies, and usefulness was assessed in 18 of the 33 studies. Usability of mHealth apps was above industry average, with median System Usability Scale scores ranging from 76 to 95 out of 100. CONCLUSIONS Current analyses of mHealth app usability are substandard. RCTs are rare, and validated questionnaires are infrequently consulted. Of the 3 domains of usability, only satisfaction is regularly assessed. There is significant bias throughout the literature, particularly with regards to conflicts of interest. Future studies should adhere to the MAUQ to assess usability and improve the utility of mHealth apps.
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Affiliation(s)
- Ben Patel
- Guy's and St Thomas' Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Arron Thind
- East Surrey Hospital, Redhill, United Kingdom
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Keng CJS, Goriawala A, Rashid S, Goldstein R, Schmocker S, Easson A, Kennedy E. Home to Stay: An Integrated Monitoring System Using a Mobile App to Support Patients at Home Following Colorectal Surgery. J Patient Exp 2020; 7:1241-1246. [PMID: 33457571 PMCID: PMC7786720 DOI: 10.1177/2374373520904194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Patients undergoing colorectal surgery are vulnerable during their transition from hospital to home and require increased support following discharge from hospital. Study objectives were to perform an initial assessment of patient uptake, outcomes, and satisfaction with an integrated discharge monitoring system called Home to Stay. Methods: The intervention was an integrated discharge monitoring system that uses a mobile app platform. Patients downloaded the app prior to discharge from hospital and received a Daily Health Check day #1 to #14, #21, and #30. Patient responses’ were accessed by the health-care team via secure web site, and extreme responses were “flagged” to indicate that a follow-up telephone call was necessary. Primary outcomes were patient uptake, Quality of Recovery scores and satisfaction with the program. Secondary outcomes were 30-day emergency room (ER) visits and readmissions. Results: One hundred and thirty-two patients were invited to participate and 106 accepted. Of these, 93 used the app at least once. The mean overall score on the Quality of Recovery Scale increased significantly from day 1 to day 14. Patient satisfaction with the app was high, with 92% of patients reporting overall satisfaction as good or excellent. The 30-day readmission rate was 6% and was lower than the 30-day readmission rate of 18% reported for the 4 months prior to the start of the study. Conclusions: The Home to Stay Program to support patients at home after colorectal surgery is feasible with high patient uptake and satisfaction. This program has the potential to reduce 30-day readmissions, however further studies are required.
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Affiliation(s)
- Christine J S Keng
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Alifiya Goriawala
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Saira Rashid
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Goldstein
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Selina Schmocker
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra Easson
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Erin Kennedy
- Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Erin Kennedy, Mount Sinai Hospital, 449-600 University Ave, Toronto, Ontario, Canada M5G 1X5.
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14
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Jaensson M, Dahlberg K, Nilsson U. Factors influencing day surgery patients' quality of postoperative recovery and satisfaction with recovery: a narrative review. Perioper Med (Lond) 2019; 8:3. [PMID: 31139359 PMCID: PMC6530125 DOI: 10.1186/s13741-019-0115-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023] Open
Abstract
The aim of healthcare services is to provide a high quality of care. One way to ensure that this aim has been fulfilled is to assess patients' satisfaction with their care. Although satisfaction is a complex concept, it is an important outcome in perioperative care. The objective of this paper is to discuss and reflect on factors that can affect patients' quality of postoperative recovery and satisfaction with recovery after day surgery. Involving patients in shared decision-making (SDM) and providing sufficient preoperative and postoperative information can improve their satisfaction. It is important to assess whether patients experience poor recovery, which can be both distressing and dissatisfying. We suggest that patients' age, sex, mental health status, and health literacy (HL) skills should be assessed preoperatively, since these factors seem to have a negative impact on patients' postoperative recovery. Identifying factors that have a negative impact on patients' quality of postoperative recovery and satisfaction with recovery after day surgery will assist healthcare professionals in supporting vulnerable patients, such as those with limited HL and poor mental health. Treating patients with respect and dignity and providing SDM can increase their quality of postoperative recovery and satisfaction with recovery.
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Affiliation(s)
- Maria Jaensson
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden
| | - Karuna Dahlberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden
| | - Ulrica Nilsson
- Division of Nursing, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
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15
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De La Cruz Monroy MFI, Mosahebi A. The Use of Smartphone Applications (Apps) for Enhancing Communication With Surgical Patients: A Systematic Review of the Literature. Surg Innov 2019; 26:244-259. [DOI: 10.1177/1553350618819517] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background. The widespread use and development of smartphones and mHealth apps has the potential to overcome communication deficiencies in health care. Objective. To carry out a literature review of studies that evaluate patients’ experience on the use of perioperative mHealth apps. Methods. An up-to-date systematic review on studies assessing patients’ use of mHealth apps for communicating with the health care team in the perioperative period was performed following the PRISMA statement. Results. Ten studies (in 11 articles) were identified: 8 feasibility studies and 2 randomized controlled trials. Nine studies included apps used for postoperative monitoring while 1 study also provided preoperative guidance. Discussion. An analysis of barriers and motivations of patients and health care professionals to the use of perioperative mHealth apps was performed. Barriers included patients’ lack of confidence when using apps and potential lack of time from health care professionals to monitor information submitted by patients. Motivations included patients’ sense of being looked after and potential cost-effectiveness and increased efficiency of health care services. This analysis led to the concept of the “ideal app” that would need to be developed following adequate protocols and security standards. Features of the ideal app include preoperative advice on medications and investigations, information on surgery, and a remote follow-up tool to improve safety and to minimize unnecessary clinic appointments and associated costs. Conclusion. There is an overall positive impression of the use of perioperative mHealth apps. However, further studies are required to assess the impact that they have on patients’ care and healthcare professional services.
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Affiliation(s)
| | - Afshin Mosahebi
- University College London, London, UK
- Leicester Royal Infirmary, Leicester, UK
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Tang MY, Li ZC, Dai Y, Li XL. What Kind Of A Mobile Health App Do Patients Truly Want? A Pilot Study Among Ambulatory Surgery Patients. Patient Prefer Adherence 2019; 13:2039-2046. [PMID: 31824139 PMCID: PMC6900404 DOI: 10.2147/ppa.s220207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND An increasing number of surgeries are performed as ambulatory surgeries, and mobile health applications (m-health apps) have therefore been designed to help provide patients with more convenient health-care services and improve the working efficiency of health-care professionals (HCPs). To find an effective approach to design such m-health apps, a study to evaluate ambulatory surgery patients' preferences is necessary. METHODS A structured questionnaire was distributed to 360 patients undergoing ambulatory surgery to understand their demographic characteristics, preferences regarding the features and functions of m-health apps and willingness to engage with m-health apps. RESULTS In total, 84.16% of ambulatory surgery patients stated that they would be willing to engage with an m-health app during the perioperative period. In addition, their top 10 necessary features and functions of m-health apps were related mainly to ambulatory surgery and communication with HCPs. Furthermore, younger age (χ 2=10.42, p<0.01), employment (χ 2=9.04, p<0.01), higher education (χ 2=13.67, p<0.01), longer daily use of phones (χ 2=11.84, p<0.01) and more frequent usage of m-health apps (χ 2=23.23, p<0.01) were associated with patients' willingness to engage with m-health apps, but only more frequent usage of m-health apps (OR=2.97, 95% CI=1.54-5.71, p<0.01) was found to be a predictor. CONCLUSION This study presents an initial evaluation of ambulatory surgery patients' preferences regarding m-health apps. Gaining these insights will be useful to help us design an evidence-based, highly functional m-health app that best meets the needs of patients undergoing ambulatory surgery.
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Affiliation(s)
- Meng-Yan Tang
- Ambulatory Surgery Center, West China Hospital, Sichuan University, ChengDu, SiChuan610041, People’s Republic of China
| | - Zhi-Chao Li
- Ambulatory Surgery Center, West China Hospital, Sichuan University, ChengDu, SiChuan610041, People’s Republic of China
| | - Yan Dai
- Ambulatory Surgery Center, West China Hospital, Sichuan University, ChengDu, SiChuan610041, People’s Republic of China
| | - Xiao-Ling Li
- Ambulatory Surgery Center, West China Hospital, Sichuan University, ChengDu, SiChuan610041, People’s Republic of China
- Correspondence: Xiao-Ling Li School of Nursing, Sichuan University, Guoxue Alley No.37, Wuhou District, ChengDu, SiChuan610041, People’s Republic of ChinaTel +86-15828231215 Email
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17
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Croghan SM, Carroll P, Reade S, Gillis AE, Ridgway PF. Robot Assisted Surgical Ward Rounds: Virtually Always There. JOURNAL OF INNOVATION IN HEALTH INFORMATICS 2018; 25:982. [PMID: 29717953 DOI: 10.14236/jhi.v25i1.982] [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: 09/19/2017] [Accepted: 11/28/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND While an explosion in technological sophistication has revolutionized surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation. Use of telepresence allowing off-site clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive, static devices. We designed a prospective study to ascertain feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients. This device is, uniquely, lightweight, freely mobile and emulates 'human' interaction by swiveling and adjusting height to patients' eye-level. METHODS: Robot-assisted ward rounds(RASWR) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRoboticstm, California USA). Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs. The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as control group. Data were paired, and non-parametric analysis performed. RESULTS: RASWRs are feasible (>90% completed without technical difficulty). The RASWR(n=52 observations) demonstrated face validity with strong correlations (r>0.7; Spearman, p-value <0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%, n=25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/NCHD cohort (100% (n=11) willing to regularly partake in RASWR). CONCLUSION: RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be physically present.
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