Balakrishnan Ashwin S, Nguyen Hao G, Shinohara Katsuto, Au Yeung Reuben, Carroll Peter R, Odisho Anobel Y
Department of Urology, University of California San Francisco, San Francisco, CA, United States.
Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, United States.
J Med Internet Res. 2019 Jun 2;21(6):e14094. doi: 10.2196/14094.
Inadequate patient education and preparation for office-based procedures often leads to delayed care, poor patient satisfaction, and increased costs to the health care system. We developed and deployed a mobile health (mHealth) reminder and education program for patients scheduled for transrectal prostate biopsy.
We aimed to evaluate the impact of an mHealth reminder and education program on appointment cancellation rates, communication frequency, and patient satisfaction.
We developed a text message (SMS, short message service)-based program with seven reminders containing links to Web-based content and surveys sent over an 18-day period (14 days before through 3 days after prostate biopsy). Messages contained educational content, reminders, and readiness questionnaires. Demographic information, appointment cancellations or change data, and patient/provider communication events were collected for 6 months before and after launching the intervention. Patient satisfaction was evaluated in the postintervention cohort.
The preintervention (n=473) and postintervention (n=359) cohorts were composed of men of similar median age and racial/ethnic distribution living a similar distance from clinic. The postintervention cohort had significantly fewer canceled or rescheduled appointments (33.8% vs 21.2%, P<.001) and fewer same-day cancellations (3.8% vs 0.5%, P<.001). There was a significant increase in preprocedural telephone calls (0.6 vs 0.8 calls per patient, P=.02) in the postintervention cohort, but not a detectable change in postprocedural calls. The mean satisfaction with the program was 4.5 out of 5 (SD 0.9).
An mHealth periprocedural outreach program significantly lowered appointment cancellation and rescheduling and was associated with high patient satisfaction scores with a slight increase in preprocedural telephone calls. This led to fewer underused procedure appointments and high patient satisfaction.
患者对门诊手术的教育和准备不足往往会导致护理延迟、患者满意度低以及医疗保健系统成本增加。我们为计划接受经直肠前列腺活检的患者开发并部署了一个移动健康（mHealth）提醒和教育项目。
我们旨在评估mHealth提醒和教育项目对预约取消率、沟通频率和患者满意度的影响。
我们开发了一个基于短信（SMS，短消息服务）的项目，包含七条提醒信息，其中包含指向基于网络内容的链接以及在18天内（前列腺活检前14天至活检后3天）发送的调查问卷。信息包含教育内容、提醒和准备情况问卷。在干预措施实施前后的6个月内收集人口统计学信息、预约取消或更改数据以及患者/提供者沟通事件。在干预后队列中评估患者满意度。
干预前（n = 473）和干预后（n = 359）队列由年龄中位数和种族/族裔分布相似、居住距离诊所相近的男性组成。干预后队列中取消或重新安排的预约显著减少（33.8%对21.2%，P <.001），当天取消的预约也减少（3.8%对0.5%，P <.001）。干预后队列中术前电话沟通显著增加（每位患者0.6次对0.8次，P =.02），但术后电话沟通无明显变化。对该项目的平均满意度为4.5分（满分5分，标准差0.9）。
一个mHealth围手术期外展项目显著降低了预约取消和重新安排的情况，并与高患者满意度评分相关，同时术前电话沟通略有增加。这导致未充分利用的手术预约减少，患者满意度高。
