SESSION TITLE: 21st Century Technology
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Wednesday, October 28, 2015 at 08:45 AM - 10:00 AM
PURPOSE: Patients are routinely given written instructions to prepare for surgery. At discharge from hospital further written instructions are given to patients. Less than 40% of patients read those instructions and less than 20% can articulate important information contained within the instructions. We created electronic reminders and web-based modules to improve patient compliance to pre-operative instructions. We wanted to reduce the number of post-operative ER visits and complications by detecting concerns early.
METHODS: All patients received the standard written instructions. A total of 54 patients undergoing thoracic surgery received automated, prescheduled messages via text message (SMS) 2 weeks leading up to surgery. The messages contained reminders for important preoperative instructions and each message was delivered on a specific day before the surgery date. Post-operatively patients were asked to keep a digital log of symptoms. Based on their entries, suggestions would be delivered to their mobile devices that instructions to deal with their symptoms. We tracked pre-operative and post-operative failures defined as deviations from the expected clinical course. The number of failures were compared to a historical control group of 50 patients.
RESULTS: Prior to implementing the digital reminders and log, our team had 6 pre-operative failures (3 patients failed to stop anticoagulation, 2 failed to bring information to pre-operative visit and 1 patient was a "no show") and 4 post-operative failures (2 wound infections that did not seek attention, 1 pneumonia found at first post-operative visit, 2 "unnecessary" ER visits). After implementation of the mobile application, there we 0 pre-operative failures and 0 post-operative failures. Patient satisfaction surveys indicate 100% of users were happy with the product.
CONCLUSIONS: The use of pre-operative SMS reminders as well as having patients log post-operative progress and symptoms significantly reduces the risk of cancellations for procedures and decreases post-operative ER visits. The mobile application significantly improves patient satisfaction by empowering patients with more information about their progress and giving them better access to their surgeon using web-based videos.
CLINICAL IMPLICATIONS: Our mobile application will improve communication with patients, increase patient satisfaction, decrease ER visits and improve patient outcomes following thoracic surgery.
DISCLOSURE: The following authors have nothing to disclose: Carmine Simone, Robert Zeldin, Najib Safieddine, Joshua Liu, Philip Chen
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