Home to Stay: An Integrated Monitoring System Using a Mobile App to Support Patients at Home Following Colorectal Surgery

Abstract

Background: Patients undergoing colorectal surgery are vulnerable during their transition from hospital to home and require increased support following discharge from hospital. Study objectives were to perform an initial assessment of patient uptake, outcomes, and satisfaction with an integrated discharge monitoring system called Home to Stay. Methods: The intervention was an integrated discharge monitoring system that uses a mobile app platform. Patients downloaded the app prior to discharge from hospital and received a Daily Health Check day #1 to #14, #21, and #30. Patient responses’ were accessed by the health-care team via secure web site, and extreme responses were “flagged” to indicate that a follow-up telephone call was necessary. Primary outcomes were patient uptake, Quality of Recovery scores and satisfaction with the program. Secondary outcomes were 30-day emergency room (ER) visits and readmissions. Results: One hundred and thirty-two patients were invited to participate and 106 accepted. Of these, 93 used the app at least once. The mean overall score on the Quality of Recovery Scale increased significantly from day 1 to day 14. Patient satisfaction with the app was high, with 92% of patients reporting overall satisfaction as good or excellent. The 30-day readmission rate was 6% and was lower than the 30-day readmission rate of 18% reported for the 4 months prior to the start of the study. Conclusions: The Home to Stay Program to support patients at home after colorectal surgery is feasible with high patient uptake and satisfaction. This program has the potential to reduce 30-day readmissions, however further studies are required.

Home to Stay: A Randomized Controlled Trial Evaluating the Effect of a Postdischarge Mobile App to Reduce 30-Day Readmission Following Elective Colorectal Surgery

“…Home to Stay is an integrated discharge monitoring program using a mobile app platform that was developed to support the needs of patients following discharge after colorectal surgery 8 (Fig. 1).…”

Remote Monitoring of Colorectal Cancer Survivors Using a Smartphone App and Internet of Things–Based Device: Development and Usability Study

“…In this study, web software technologies and mobile apps were used. In similar studies, Mayer et al [ 41 ], Cheong et al [ 42 ], Keng et al [ 26 ], and Miller et al [ 22 ] used mobile and web applications were used. In the Maxwell-Smith et al [ 43 ] study, there is no reference to the technology applied in the system software.…”

“…Also, more specific studies have been carried out for postoperative telemonitoring, education, and self-care in CRC [ 22 - 25 ]. For example, Keng et al [ 26 ] developed an integrated discharge monitoring system based on a mobile app to support patients at home after colorectal surgery. Their study included 106 participants, and 93 of them used the designed apps.…”

Mobile applications in gastrointestinal surgery: a systematic review

“…These apps had a completion rate of the daily assessments between 21 and 84%, and had good patient satisfaction. [14][15][16][17][18][19][20][21][22][23][24]. The app of Keng et al had a 30-day readmission rate of 6% in comparison with a reported rate of 18% prior to the start of the cohort study [14].…”