Matthew H G Katz1, Rebecca Slack2, Morgan Bruno3, Jermaine McMillan4, Jason B Fleming3, Jeffrey E Lee3, Brian Bednarski5, John Papadopoulos6, Surena F Matin6. 1. The Minimally Invasive New Technologies in Oncologic Surgery (MINTOS) Cooperative Group, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: mhgkatz@mdanderson.org. 2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas. 3. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 4. The Minimally Invasive New Technologies in Oncologic Surgery (MINTOS) Cooperative Group, The University of Texas MD Anderson Cancer Center, Houston, Texas. 5. The Minimally Invasive New Technologies in Oncologic Surgery (MINTOS) Cooperative Group, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. 6. The Minimally Invasive New Technologies in Oncologic Surgery (MINTOS) Cooperative Group, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Outpatient clinical encounters are used to promote recovery after complex surgical procedures for cancer. These care episodes are resource intensive. Virtual clinical encounters (VCEs) can now be conducted using widely available videoconferencing technologies. However, whether these technologies may be used to monitor postoperative recovery is unknown. METHODS: In this pilot study, we provided care using a comprehensive "TeleDischarge" protocol to 15 patients after pancreatectomy. In addition to routine follow-up, all patients participated in two scheduled and an unlimited number of unscheduled VCEs using mobile hardware and secure videoconferencing software. We evaluated feasibility, patient satisfaction, postoperative adverse events, and health care human resource utilization. RESULTS: The median age of enrolled patients was 63 y (range, 52-83 y) and 93% underwent pancreatoduodenectomy. Twenty-eight scheduled VCEs (93%) were completed successfully, and only one unscheduled VCE was requested. Twelve patients (80%) felt their postoperative care was enhanced by VCEs and 14 (93%) felt that VCEs should be a regular part of postoperative care. Minor interventions in four patients (27%) were performed on the basis of clinical data gathered during a VCE. On a per patient basis, the TeleDischarge pathway was estimated to take 36 min longer and to have a direct labor cost $39 greater than the standard pathway. CONCLUSIONS: Secure VCEs can be conducted using widely available hardware and software solutions. Although cancer patients support the introduction of mobile technology into postoperative care, further studies are needed to identify ways in which such technology can be used most effectively and efficiently to reduce barriers to recovery.
BACKGROUND:Outpatient clinical encounters are used to promote recovery after complex surgical procedures for cancer. These care episodes are resource intensive. Virtual clinical encounters (VCEs) can now be conducted using widely available videoconferencing technologies. However, whether these technologies may be used to monitor postoperative recovery is unknown. METHODS: In this pilot study, we provided care using a comprehensive "TeleDischarge" protocol to 15 patients after pancreatectomy. In addition to routine follow-up, all patients participated in two scheduled and an unlimited number of unscheduled VCEs using mobile hardware and secure videoconferencing software. We evaluated feasibility, patient satisfaction, postoperative adverse events, and health care human resource utilization. RESULTS: The median age of enrolled patients was 63 y (range, 52-83 y) and 93% underwent pancreatoduodenectomy. Twenty-eight scheduled VCEs (93%) were completed successfully, and only one unscheduled VCE was requested. Twelve patients (80%) felt their postoperative care was enhanced by VCEs and 14 (93%) felt that VCEs should be a regular part of postoperative care. Minor interventions in four patients (27%) were performed on the basis of clinical data gathered during a VCE. On a per patient basis, the TeleDischarge pathway was estimated to take 36 min longer and to have a direct labor cost $39 greater than the standard pathway. CONCLUSIONS: Secure VCEs can be conducted using widely available hardware and software solutions. Although cancerpatients support the introduction of mobile technology into postoperative care, further studies are needed to identify ways in which such technology can be used most effectively and efficiently to reduce barriers to recovery.
Authors: B K Bednarski; T P Nickerson; Y N You; C A Messick; B Speer; V Gottumukkala; M Manandhar; M Weldon; E M Dean; W Qiao; X Wang; G J Chang Journal: Br J Surg Date: 2019-06-19 Impact factor: 6.939
Authors: Hardeep Singh; Terence Tang; Carolyn Steele Gray; Kristina Kokorelias; Rachel Thombs; Donna Plett; Matthew Heffernan; Carlotta M Jarach; Alana Armas; Susan Law; Heather V Cunningham; Jason Xin Nie; Moriah E Ellen; Kednapa Thavorn; Michelle LA Nelson Journal: JMIR Aging Date: 2022-05-19
Authors: Brian K Bednarski; Rebecca S Slack; Matthew Katz; Y Nancy You; John Papadopolous; Miguel A Rodriguez-Bigas; John M Skibber; Surena F Matin; George J Chang Journal: Dis Colon Rectum Date: 2018-01 Impact factor: 4.585