Mobile apps for ambulatory surgery follow-up show promising signs
Friday, March 31, 2017
Mobile apps in healthcare may finally be taking hold and finding some relevance in the sector, at least in one specific area — breast reconstruction. Specifically, the journal JAMA Surgery reports that access to a mobile app allowed ambulatory breast reconstruction patients to submit photos to their physicians and report information to physicians, resulting in fewer post-surgery follow-up appointments.
The mobile follow-up sessions meant that patients and their caregivers could easily engage each other over their devices, establishing an obvious benefit for both the patient and the physician — fewer appointments requiring management for the physician and less time wasted getting to the physician for the patient.
The results of the JAMA study, while quite a small sample, are obviously encouraging. Let's take a look.
Out of 65 women treated between Feb. 1, 2015, and August 31, 2015, (quite a long time ago in technology terms, but worth noting) 32 women with access to the app attended a mean of 0.66 in-person visits while 33 women without the app attended a mean of 1.64 in-person visits.
Additionally, there were no significant differences in telephone calls with physicians, satisfaction scores or complications between the two groups, although women with access to the app sent more emails to their physicians and reported higher convenience scores.
One obstacle that has hindered adoption of technology in healthcare has been doubt over its ability to replace in-person care. However, results such as these are slowly helping to break down barriers holding technology back, especially as patients increasingly indicate their preference for more consumer-friendly services, Healthcare Dive reports.
The results of the study are pretty stark. Out of 32 women in the study who had access to the app, 30 (97 percent) said they "agreed" or "strongly agreed" that their follow-up care was convenient. Only 16 of 33 (less than 50 percent) women without access to the app "agreed" or "strongly agreed" that their follow-up care was convenient.
This response lends credence to surveys that suggest patients would appreciate digital tools that allow communication with their physicians. The fewer trips to the doctor's office the better, this survey seems to suggest.
The process worked like this for these women: Their procedures are performed on an ambulatory basis. JAMA reports that all patients go home on the day of or the day after surgery; patients also often travel significant distances to receive this care — not unique to patients who undergo breast reconstruction.
Of course, it likely helps that in general, the morbidity and mortality rates following ambulatory surgery, and surgery such as this, are low. Complication rates in this subset of patients undergoing breast reconstruction are approximately 5 percent to 7.5 percent, making most follow-up visits perfunctory.
The specific technology used was created by QoC Health, a mobile app that allows patients to submit photographs and answers to a validated quality of recovery questionnaire and a pain visual analog scale using a mobile device for the first 30 days after the operation.
"Surgeons are able to follow patient reports on a web portal," notes JAMA. "This technology has been used for patients who have undergone ambulatory breast reconstruction. Our study builds on pre-existing data by determining whether receiving follow-up via the mobile app can avert the need for in-person follow-up care."
Following this initial trial, other healthcare providers have begun to experiment with new care delivery systems that rely on similar technology. One Medical, which operates a network of retail clinics, allows patients email and video chat with physicians, send photographs, refill prescriptions and schedule appointments via a website and mobile app, the study notes.
The secret to success here may be that the technology must be easy for patients to use.
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