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

Autor: Allyson Cochran, Emily Bhattacharya, John B. Martinie, Dionisios Vrochides, Lee M. Ocuin, Lacey King, R.C. Pickens, Erin H. Baker, Denice Koo, Kendra Tezber, Jarrett Hunt, David A. Iannitti, Renna Berry
Rok vydání: 2019
Předmět:
Program evaluation
medicine.medical_specialty
medicine.medical_treatment
media_common.quotation_subject
Pilot Projects
Perioperative Care
Pancreaticoduodenectomy
03 medical and health sciences
Pancreatectomy
0302 clinical medicine
Quality of life (healthcare)
Patient satisfaction
Computer Systems
Health care
medicine
Hepatectomy
Humans
Patient Reported Outcome Measures
Prospective Studies
030212 general & internal medicine
media_common
Postoperative Care
Pain
Postoperative
business.industry
Convalescence
General Medicine
Mobile Applications
Surgery
Analgesics
Opioid
Elective Surgical Procedures
Patient Satisfaction
030220 oncology & carcinogenesis
Postoperative Nausea and Vomiting
Quality of Life
Patient Compliance
medicine.symptom
business
Elective Surgical Procedure
Postoperative nausea and vomiting
Program Evaluation
Zdroj: The American Surgeon. 85:909-917
ISSN: 1555-9823
0003-1348
Popis: 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.
Databáze: OpenAIRE
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