Department of Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, Sittard-Geleen, 6162 BG, Heerlen, The Netherlands.
World J Surg. 2023 Jan;47(1):182-189. doi: 10.1007/s00268-022-06590-1. Epub 2022 May 23.
E-Health care is already well established in some (non-) surgical specialties and is considered as a means of improving patient-centred care. Considering the demand of remote health care changes, especially in the COVID-19 pandemic, it is essential to investigate the feasibility of e-Health care within one of the most performed surgery procedures: inguinal hernia repair.
A total of 60 patients used the e-Health application in this study compliant. Primary objectives were to investigate the accuracy of the "deviating post-operative course" alerting by the e-Health application. Secondary objectives included patient perspective and e-Health costs analysis.
Forty-four patients reported no deviation in the post-operative course using the e-Health application of which 93.2% (n = 41) was in concordance with the findings during standard follow-up. Within 16 patients reporting a deviating post-operative course, a true complication was found in 25% (n = 4). Based on in-hospital costs, a hypothetical e-Health follow-up scenario was more expensive (€59.5 per patient) than current standard follow-up care (€28.2 per patient). Usage of the e-Health application showed a high perceived overall patient satisfaction: 4.2 (on a Likert-scale of 1-5).
An e-Health application is a promising tool for identifying patients who require in-person or phone follow-up assessment. Patients' perspectives surveys revealed high potential and willingness of using this application. A hypothetical e-Health follow-up scenario showed to be more expensive compared to current standard follow-up. If the identified (dis)advantages can be improved, e-Health follow-up care appears to be promising in terms of safety and feasibility. Future studies can leverage on this study and further investigate the use of e-Health within the field of general surgery.
电子医疗保健在一些（非）外科专业中已经得到广泛应用，并被认为是改善以患者为中心的医疗服务的一种手段。考虑到远程医疗需求的变化，特别是在 COVID-19 大流行期间，调查电子医疗保健在最常进行的手术之一——腹股沟疝修补术中的可行性至关重要。
本研究共有 60 名患者使用了电子医疗应用程序。主要目标是调查电子医疗应用程序发出的“术后异常情况”警报的准确性。次要目标包括患者角度和电子医疗成本分析。
44 名患者报告在使用电子医疗应用程序时术后过程没有异常，其中 93.2%（n=41）与标准随访中的发现一致。在报告术后异常情况的 16 名患者中，有 25%（n=4）发现了真正的并发症。基于住院费用，假设的电子医疗随访方案比当前的标准随访护理（每名患者 28.2 欧元）更昂贵（每名患者 59.5 欧元）。电子医疗应用程序的使用显示出较高的总体患者满意度：4.2（Likert 量表 1-5 级）。
电子医疗应用程序是识别需要亲自或电话随访评估的患者的有前途的工具。患者角度调查显示出使用该应用程序的高潜力和意愿。假设的电子医疗随访方案比当前的标准随访成本更高。如果可以改进所识别的（不利）优势，电子医疗随访护理在安全性和可行性方面似乎很有前景。未来的研究可以借鉴本研究，并进一步调查电子医疗在普通外科领域的应用。
