The potential impacts of a digital preoperative assessment service on appointments, travel-related CO2 emissions, and user experience: a case study (Preprint)

Abstract

The NHS cannot keep up with the demand for operations and procedures. Preoperative assessments, which can last 30 minutes to 2 hours, could be conducted online to save patient and clinician time, reducing wait times for operations. MyPreOp is a cloud-based platform where patients can set up an account and complete their preoperative questionnaires. This data is reviewed by a nurse, who determines if they need a subsequent face-to-face appointment.

The primary objective was to describe the potential impact of MyPreOp® (Ultramed Ltd, Penryn, UK) the number of face-to-face appointments. Secondary objectives were to examine the time spent on preoperative assessments completed using MyPreOp in everyday use in NHS Trusts and user ratings of usability and acceptability.

A case study service evaluation of data collected by the MyPreOp system from two NHS Trusts (Guy’s and St Thomas’ and Royal United Hospitals Bath) and the private BMI Bath Clinic during the four-month period of September to December 2020. MyPreOp is delivered by the hospital conducting the preoperative assessment but is typically completed at home at the patients’ convenience. Participants were adults of any age and health status at the participating hospitals who used MyPreOp to complete a preoperative assessment before a scheduled surgery. The primary outcome was the number of face-to-face appointments avoided by patients who used MyPreOp. Secondary outcomes were the length of time spent by nurses completing preoperative assessments, associated travel-related CO2 emissions, and quantitative user feedback.

Data from 2,500 participants was included. Half of the patients assessed did not need a further face-to-face appointment and required a median of only 5.3 minutes of nurses’ time. The reduction in appointments was associated with a small saving of CO2e emissions (9.05 tonnes). Patient feedback was generally positive: 80% of respondents rated MyPreOp as easy or very easy to use and 85% thought the overall experience was good or very good.

This evaluation demonstrated potential benefits of MyPreOp. However, further research using rigorous scientific methodology and a larger sample of NHS Trusts and users is needed to provide strong evidence of MyPreOp’s efficacy, usability, and cost-effectiveness.