Efficiency and acceptability of an automated electronic system (DayCOR) compared with a telephone call system, for follow-up of day surgery patients

Abstract

Post-discharge phone calls are a widely used yet suboptimal method of ascertaining recovery of day surgery patients. We compared the efficiency of an automated electronic system of follow-up, the Day Care Anaesthesia Outcomes Recording Registry (DayCOR), and a telephone call system that was standard practice in our non-profit private healthcare organisation in Victoria, Australia. We also surveyed a group of clinicians to assess their acceptance of DayCOR compared with the telephone call system. DayCOR is a web-based system which collects, alerts, manages and analyses patient-reported outcomes. Patients may opt in to respond to a 15-question survey via a link sent by text message or email. DayCOR’s patient response rate was 77.5%, compared with 66.0% for the telephone call system. Both systems collected data on clinical, process, and experience outcomes. Completeness of data collection was 100% using DayCOR compared with 51%–61.4% of data items using the telephone call system. We estimated that replacing our telephone call system with DayCOR to follow up 60,000 day surgery patients a year would represent an annual cost reduction of AUD$101,345 (53%) using manual demographic data entry, and AUD$142,745 (74%) if DayCOR was integrated with the institution’s existing administrative software. Seventy-eight percent of day surgery nurses and 94% of anaesthetists preferred DayCOR to the telephone call system. All anaesthetists surveyed stated that DayCOR provided more valuable feedback, and almost one-fifth had changed their clinical practice as a result. DayCOR’s efficiency and acceptability will allow more effective collection of post-discharge patient outcomes than is currently possible in our institution, and will support interventional studies aimed at improving quality of recovery of day surgery patients.

Feasibility of remote digital monitoring using wireless Bluetooth monitors, the Smart Angel™ app and an original web platform for patients following outpatient surgery: a prospective observational pilot study

“…Previous studies have described the effect of patients reporting their postoperative recovery after day surgery [11]. Web-based systems collecting alerts, managing and analysing patient-reported outcomes have been added to provide more valuable feedback [12]. The main limitation of these systems is the absence of remote data on physical parameters such as heart or respiratory rates, oxygen saturation and blood pressure.…”

Efficiency and acceptability of an electronic follow-up system (DayCOR) for paediatric patients

“…Efficiency and acceptability of an electronic follow-up system (DayCOR) for paediatric patients Nicole LT Tan 1 , Kenneth W Sleeman 2 and John R Sestan 3 We note with interest the results of the survey by Smallbone et al, 1 and write to provide additional support for their proposal that electronic follow-up is more efficient than telephone follow-up for clinical purposes.…”

“…In a study comparing the usual telephone call system and an electronic system (DayCOR) at one of the participating hospitals, we demonstrated significant benefits of the latter. 3 These included increased efficiency (a higher patient response rate, more complete data collection and lower cost) and increased acceptability to anaesthetists and day surgery nurses. We did not survey parents or carers, and therefore welcome Smallbone et al.’s finding of positive parental/carer attitudes towards using electronic devices and SMS messaging to follow up children after hospital discharge.…”

Author’s Reply

“…We thank Tan and Sestan for their interest in our work 1 and for their interesting additional analysis from their previously published report into the DayCOR system. 2 We are pleased to hear of the high response rate received from parents of paediatric patients when using SMS to distribute an online survey.…”

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We thank Tan and Sestan for their interest in our work 1 and for their interesting additional analysis from their previously published report into the DayCOR system. 2 We are pleased to hear of the high response rate received from parents of paediatric patients when using SMS to distribute an online survey.The use of online surveys is one method for electronic follow-up that we have considered, although we are also interested to see whether direct conversational SMS messaging provides a lower barrier to engagement-particularly for collecting longitudinal data at regular intervals during patient recovery.We are currently planning to trial such a system at our institution and look forward to showing these results in due course (Australian New Zealand Clinical Trials Registry; identifier ACTRN1261 9001028190). Further work to directly compare various electronic follow-up methods would also be a useful addition to this area of enquiry.

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