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Irfan A, Smith B, Wood L, Hollis RH, Wallace E, Rubyan M, Reddy S, Chu DI. Can screen-time help? An analysis of usage of patient engagement technology following colorectal surgery. Am J Surg 2024:S0002-9610(24)00103-X. [PMID: 38383163 DOI: 10.1016/j.amjsurg.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/25/2024] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Patient engagement technologies (PETs) guide patients through the perioperative period. We aimed to investigate the levels of patient engagement with PETs through the peri-operative period and its impact on clinical outcomes. METHODS Retrospective cohort study of patients undergoing elective colorectal surgery from 2018 to 2022. Outcomes were length of stay, readmissions, and complications within 30 days of index hospitalization. RESULTS 359 (89.1%) patients activated the PET. Patients completed a median of 7 surveys, 2 in-hospital health-checks, and 1 post-discharge health-check. Median LOS was 3 days, 57 (14.1%) patients were readmitted, and 56 (13.9%) had a complication. Patients who completed no surveys had longer LOS than those who completed 2 or more. Patients who were readmitted and had post-operative complications completed significantly fewer surveys and post-discharge health-checks. Completion of surveys in more phases was associated with shorter LOS and lower readmission rates. Completion of more post-discharge health-checks was associated with lower complication rate. CONCLUSIONS The use of PETs improves patient outcomes and experiences in the perioperative period. Patients who engage more frequently with PETs have shorter LOS with lower readmission and post-operative complication rates.
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Affiliation(s)
- Ahmer Irfan
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Burke Smith
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lauren Wood
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert H Hollis
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric Wallace
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael Rubyan
- School of Public Health, University of Michigan, MI, USA
| | - Sushanth Reddy
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Daniel I Chu
- Department of General Surgery, University of Alabama at Birmingham, Birmingham, AL, USA
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Gleason F, Baker SJ, Gleason L, Wei B, Donahue J. Patient factors related to patient engagement technology (PET) usage in thoracic surgery. Am J Surg 2024; 228:242-246. [PMID: 37932188 DOI: 10.1016/j.amjsurg.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/07/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND We evaluated using Patient Engagement Technology (PET) to capture Patient Reported Outcomes (PROs) in thoracic surgery patients. METHODSY: atients using a PET received surveys including the Patient-Reported Outcomes Measurement Information System Global-10 (PROMIS-10) and a health literacy (HL) screen. The relationship of patient-level factors with survey completion was assessed through univariate and logistic regression analyses. RESULTS 703 patients enrolled in a PET. 52 % were female and 83 % were white with a median age of 63.72 % had adequate HL. 81 % completed the PROMIS-10 survey. Univariate analysis found lower rates of PROMIS-10 completion in male patients and those with inadequate HL. Logistic regression analysis showed adequate HL (OR 1.76) and white race (OR 1.72) were associated with PROMIS-10 survey completion, while male gender (OR 0.65) had the opposite effect. CONCLUSIONS PETs are an effective means of collecting PROs, but use is affected by gender, race, and health literacy.
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Affiliation(s)
- Frank Gleason
- Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Samantha J Baker
- Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, 35233, USA
| | - Lauren Gleason
- Birmingham Veterans Administration Medical Center, Birmingham, AL, 35233, USA
| | - Benjamin Wei
- Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, 35233, USA; Birmingham Veterans Administration Medical Center, Birmingham, AL, 35233, USA
| | - James Donahue
- Department of Surgery, Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, 35233, USA; Birmingham Veterans Administration Medical Center, Birmingham, AL, 35233, USA.
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Smithson M, McLeod MC, Theiss L, Shao C, Kennedy G, Hollis R, Chu DI, Hardiman KM. Ileostomy Patients Using Patient Engagement Technology Experience Decreased Length of Stay. J Gastrointest Surg 2022; 26:635-642. [PMID: 34618324 PMCID: PMC9217180 DOI: 10.1007/s11605-021-05158-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/09/2021] [Indexed: 01/31/2023]
Abstract
Patients who undergo colorectal surgery, particularly, construction of a new ileostomy, are known to have longer length of stay (LOS) and increased readmissions. With the increased availability of patient engagement technology (PET), we hypothesized that because PET facilitates education before and after surgery, ileostomy patients who used PET would have decreased LOS without increasing readmissions. Variables were obtained from the National Surgical Quality Improvement Program (NSQIP) database for patients undergoing ileostomy construction. Study patients were categorized into three groups: pre-PET (patients prior to PET), non-PET (patients who did not use PET), and PET users (patients who used PET). Univariate analysis of patient and surgical characteristics, LOS, ED visits, and readmissions and multivariable modeling of potential predictors of LOS were performed. There were 106 patients in the pre-PET, 51 in the PET, and 108 in the non-PET and cohorts were similar except pre-op diagnosis. Length of stay was lower for the PET cohort (p = 0.0001), with no significant difference in readmission or ED visits. On multivariable analysis, we identified the PET cohort as an independent predictor of shorter LOS relative to non-PET and pre-PET (p = 0.007 and p = 0.02, respectively). Similarly, patients had significantly shorter LOS who had a diagnosis of neoplasm as compared to IBD (p = 0.03). Hypertension requiring medication (p = 0.001) and Black race relative to White race (p = 0.002) were independent predictors of longer LOS. In this study of ileostomy patients, we have shown that use of PET is an independent predictor of decreased LOS without increased ED visits or readmissions.
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Affiliation(s)
- Mary Smithson
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - M. Chandler McLeod
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Lauren Theiss
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Connie Shao
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Gregory Kennedy
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Robert Hollis
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Daniel I. Chu
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
| | - Karin M. Hardiman
- Department of Surgery, University of Alabama at Birmingham, KB 428, 1922 7thAvenue South, Birmingham, AL 35294-0016, USA
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Engelhard MM, Patek SD, Sheridan K, Lach JC, Goldman MD. Remotely engaged: Lessons from remote monitoring in multiple sclerosis. Int J Med Inform 2017; 100:26-31. [PMID: 28241935 DOI: 10.1016/j.ijmedinf.2017.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/06/2017] [Accepted: 01/07/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Evaluate web-based patient-reported outcome (wbPRO) collection in MS subjects in terms of feasibility, reliability, adherence, and subject-perceived benefits; and quantify the impact of MS-related symptoms on perceived well-being. METHODS Thirty-one subjects with MS completed wbPROs targeting MS-related symptoms over six months using a customized web portal. Demographics and clinical outcomes were collected in person at baseline and six months. RESULTS Approximately 87% of subjects completed wbPROs without assistance, and wbPROs strongly correlated with standard PROs (r>0.91). All wbPROs were completed less frequently in the second three months (p<0.05). Frequent wbPRO completion was significantly correlated with higher step on the Expanded Disability Status Scale (EDSS) (p=0.026). Nearly 52% of subjects reported improved understanding of their disease, and approximately 16% wanted individualized wbPRO content. Over half (63.9%) of perceived well-being variance was explained by MS symptoms, notably depression (rs=-0.459), fatigue (rs=-0.390), and pain (rs=-0.389). CONCLUSIONS wbPRO collection was feasible and reliable. More disabled subjects had higher completion rates, yet most subjects failed requirements in the second three months. Remote monitoring has potential to improve patient-centered care and communication between patient and provider, but tailored PRO content and other innovations are needed to combat declining adherence.
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