Using a Mobile Application for Real-Time Collection of Patient-Reported Outcomes in Hepatopancreatobiliary Surgery within an ERAS® Pathway

Author:

Pickens Ryan1,Cochran Allyson2,Tezber Kendra1,Berry Renna3,Bhattacharya Emily4,Koo Denice4,King Lacey1,Iannitti David A.1,Martinie John B.1,Baker Erin H.1,Ocuin Lee M.1,Hunt Jarrett3,Vrochides Dionisios

Affiliation:

1. Division ofHPB Surgery, Department of Surgery, Atrium Health, Charlotte, North Carolina;

2. Department of Surgery, Atrium Health, Carolinas Center for Surgical Outcomes Science, Charlotte, North Carolina;

3. Information and Analytics Services, Atrium Health, Charlotte, North Carolina; and

4. SeamlessMD®, Toronto, Canada

Abstract

Patient-reported outcomes (PROs) are essential for patient-centered health care. This pilot study implemented a mobile application customized to an hepatopancreatobiliary Enhanced Recovery After Surgery (ERAS®) program—a novel environment—for real-time collection of PROs, including ERAS® pathway compliance. Patients undergoing hepatectomy, distal pancreatectomy, or pancreaticoduodenectomy through the ERAS® program were prospectively enrolled over 10 months. The application provided education and questionnaires before surgery through 30 days postdischarge. Thresholds were set for initial adoption of the application (75%), PRO response rate (50%), and patient satisfaction (75%). Daily postdischarge health checks integrated customized responses to guide out-of-hospital care. Of 165 enrolled patients, 122 met inclusion criteria. Application adoption was 93 per cent (114/122) and in-hospital engagement remained high at 88 per cent (107/122). Patients completed 62 per cent of PRO on quality of life, postoperative pain, nausea, opioid consumption, and compliance to ERAS® pathway items, including ambulation and breathing exercises. During postcharge tracking, 12 patients reported that the application prevented a phone call to the hospital and three patients reported prevention of an emergency room visit. PRO collection through this mobile device created an integrated platform for comprehensive perioperative care, patient-initiated outcome tracking with automatic reporting, and real-time feedback for process change. Improving proactive outpatient management of complex patients through mobile technology could help restructure health-care delivery and improve resource utilization for all patients.

Publisher

SAGE Publications

Subject

General Medicine

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