Jordan Heuser, MD1, Azusa Maeda, PhD2, Caterina Masino, MA2, Timothy Jackson, MD, MPH1, Allan Okrainec, MD, MHPE1. 1Department of Surgery, Faculty of Medicine, University of Toronto, 2Division of General Surgery, University Health Network
Introduction: Despite efforts to improve recovery through the enhanced recovery after surgery (ERAS) pathway, visits to the emergency department (ED) and readmissions remain a critical issue in bariatric surgery patients. The purpose of this study is to determine the impact of a patient education mobile app on healthcare utilization and outcomes of patients undergoing bariatric surgery.
Methods: Bariatric surgery patients were recruited prospectively to use a mobile app that provides evidence-based surgical and dietary education, allows tracking of postoperative symptoms for 30 days, and alerts patients at risk of ED visits or readmission when necessary. The cohort was compared to the group of patients who did not enroll in the app for the same study period of September 2017 to April 2018. Data on 30-day readmissions, ED visits, and postoperative occurrences were collected from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database to compare the healthcare utilization between the two groups. Data from the mobile app was additionally analyzed to evaluate user satisfaction and usage rates.
Results: There were 338 bariatric surgery patients included during the study period, with 104 patients who enrolled in the mobile application. There was an equal distribution based on age, gender, BMI and type of bariatric procedure performed between patients with and without the app. There was no difference in ED visits (7/104, 6.7% vs. 14/234, 6.0%) or readmissions (6/104, 5.8% vs. 7/234, 3.0%) between patients with and without the app, respectively. The mobile app surveys indicated that the overall ratings were high (37/50, 74%) and the usage rates were high (86% of patients used the app at least once and usage was over 50% for post-operative days 1 to 7). In addition, although the MBSAQIP data revealed no difference in ED visits, the survey from the mobile app showed that 12.6% of patients perceived that they had avoided at least one ED visit.
Conclusions: Overall, patient satisfaction and use of the mobile app were high, although a reduction in ED visits and readmissions was not found despite a significant percentage of patients that reported avoided ED visits because of the mobile app. Further investigation is warranted to evaluate reduction of other healthcare resources such as nurse educators, as well as to increase the proportion of patients that enroll in the mobile app and allow for transition to a paperless patient information pamphlet.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94179
Program Number: P130
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster