Electronic collection of patient-reported outcomes following discharge after surgery: systematic review

Abstract

Background Little is known about the electronic collection and clinical feedback of patient-reported outcomes (ePROs) following surgical discharge. This systematic review summarized the evidence on the collection and uses of electronic systems to collect PROs after discharge from hospital after surgery. Method Systematic searches of MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central were undertaken from database inception to July 2019 using terms for ‘patient reported outcomes’, ‘electronic’, ‘surgery’ and ‘at home’. Primary research of all study designs was included if they used electronic systems to collect PRO data in adults after hospital discharge following surgery. Data were collected on the settings, patient groups and specialties, ePRO systems (including features and functions), PRO data collected, and integration with health records. Results Fourteen studies were included from 9474 records, including two RCTs and six orthopaedic surgery studies. Most studies (9 of 14) used commercial ePRO systems. Six reported types of electronic device were used: tablets or other portable devices (3 studies), smartphones (2), combination of smartphones, tablets, portable devices and computers (1). Systems had limited features and functions such as real-time clinical feedback (6 studies) and messaging service for patients with care teams (3). No study described ePRO system integration with electronic health records to support clinical feedback. Conclusion There is limited reporting of ePRO systems in the surgical literature, and ePRO systems lack integration with hospital clinical systems. Future research should describe the ePRO system and ePRO questionnaires used, and challenges encountered during the study, to support efficient upscaling of ePRO systems using tried and tested approaches.

Digitally supported shared decision-making and treat-to-target in rheumatology: a qualitative study embedded in a multicenter randomized controlled trial

“…A major challenge, not limited to RA and rheumatology is poor ePRO adherence [4,[6][7][8]. Poor adherence can stem from a multitude of factors, including but not limited to lack of perceived benefit [9], age and high disease activity among patients [10] or lack of integration into clinical workflows and electronic health records among professionals [11,12]. In a recent review, Wiegel et al concluded that to optimize adherence to tele-monitoring with ePRO, mixed-method studies are needed [7].…”

Mobile Postoperative Symptom Intervention Tool and Biometric Monitoring After Radical Cystectomy: Pilot Study Evaluating Feasibility, Usability, and Potential Utility

“…While electronic collection of patient-reported outcomes has been performed in several studies after cancer surgery 19 ours is the first to report daily postoperative symptoms encompassing a range of domains relevant to major abdominal and pelvic surgery. Our data suggest that electronic distribution of daily surveys via a mobile application is feasible and highly usable, with only 1 patient reporting technical difficulty accessing the study due to connectivity issues to home Wi-Fi.…”

Healthcare Value in Plastic Surgery Practice

“…23 Encouragingly, recent reports suggest that widespread collection of PROs in plastic surgery is feasible, especially with digital symptom monitoring. [24][25][26][27][28] Although health information technology shifts the burden of data collection to patients, investments in infrastructure, data teams, and adaptations to clinic workflow are still necessary. In addition to real-time monitoring by individual departments, 26 these incentives will likely also require top-down investment and cultural shifts at the hospital system level, 29 alongside pressure from payers for outcome collection.…”