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连接式追踪解决方案在结直肠手术患者围手术期随访中的获益与局限。

Gains and limitations of a connected tracking solution in the perioperative follow-up of colorectal surgery patients.

机构信息

Department of Visceral Surgery, Lausanne University Hospital (CHUV), University of Lausanne (UNIL), Lausanne, Switzerland.

出版信息

Colorectal Dis. 2020 Aug;22(8):959-966. doi: 10.1111/codi.14998. Epub 2020 Feb 27.

Abstract

AIM

The means to target shorter hospital stay include information technology strategies to improve communication between caregivers and patients in order to limit potentially avoidable readmissions. The aim of the present study was to analyse the benefits and limitations of a smartphone-based connected tracking solution in the perioperative follow-up of colorectal surgery patients.

METHOD

This was a retrospective monocentric cohort study of consecutive patients after colorectal surgery between February and December 2018. The mobile health application included information delivery and daily structured questionnaires on a personalized patient electronic profile, before the hospital stay and for 7 days post-discharge. The medical team answered automatic alerts in real time.

RESULTS

A total of 93 eligible patients were approached and 36 had to be excluded (26 no smartphone, five no email, five not French speaking). Among the potential users, 50 (88%) engaged in an mHealth app and seven refused. Of these 50 patients, seven dropped out. Of the remaining 43 patients, the app detected 12 adverse events, and 10 (83%) were handled through the app. Healthcare providers responded to patient-generated alerts after a median time of 90 min (range 9-448 min). Patients' mean satisfaction level was 4 ± 0.97 out of 5.

CONCLUSION

In total, 88% of smartphone-equipped patients showed a willingness to engage in mHealth. Reasons for exclusion were the absence of connection tools and a language barrier. Patients who responded to the survey were satisfied with the solution and 83% of post-discharge adverse events were solved through the app, avoiding emergency consultations.

摘要

目的

旨在缩短住院时间的方法包括信息技术策略,以改善护理人员与患者之间的沟通,从而限制潜在的可避免再次入院。本研究旨在分析基于智能手机的互联跟踪解决方案在结直肠手术后患者围手术期随访中的获益和局限性。

方法

这是一项回顾性单中心队列研究,纳入了 2018 年 2 月至 12 月期间连续接受结直肠手术后的患者。移动医疗应用程序包括在住院前和出院后 7 天内向患者个人电子档案发送信息和每日结构化问卷。医疗团队实时回答自动警报。

结果

共接触了 93 名符合条件的患者,其中 36 名被排除(26 名无智能手机、5 名无电子邮件、5 名不讲法语)。在潜在用户中,有 50 名(88%)使用了移动健康应用程序,有 7 名拒绝使用。这 50 名患者中有 7 名退出。在剩下的 43 名患者中,该应用程序检测到 12 起不良事件,其中 10 起(83%)通过应用程序处理。医疗服务提供者在收到患者生成的警报后中位数时间为 90 分钟(范围 9-448 分钟)做出回应。患者的平均满意度为 4±0.97(满分 5 分)。

结论

总的来说,88%配备智能手机的患者表示愿意参与移动医疗。排除的原因是缺乏联系工具和语言障碍。参与调查的患者对该解决方案感到满意,83%的出院后不良事件通过该应用程序解决,避免了紧急咨询。

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