Implementation Challenges Using a Novel Method for Collecting Patient-Reported Outcomes After Injury

Rosenberg, Graeme; Shearer, Emily; Zion, Sean R.; Mackey, Sean; Morris, Arden M.; Spain, David A.; Weiser, Thomas

doi:10.1016/j.jss.2019.04.008

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…Overall, 95% of patients were able to complete their registration in the mHealth platform, and 80% were successful in sharing their electronic health data. Several challenges were identified within this pilot, including logistical, technical and patient-specific barriers, most of which have been identified in other non ED-based mHealth PRO surveys [ 24 ]. We identified several challenges consistent with prior pilot studies of mHealth platforms, including difficulty retaining email, mHealth and EHR login information, and integrating enrollment into clinical care; technical issues included challenges with Wi-Fi connectivity, delays in data uploading; and patient specific factors included overall comfort and management of clinical symptoms [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several challenges were identified within this pilot, including logistical, technical and patient-specific barriers, most of which have been identified in other non ED-based mHealth PRO surveys [ 24 ]. We identified several challenges consistent with prior pilot studies of mHealth platforms, including difficulty retaining email, mHealth and EHR login information, and integrating enrollment into clinical care; technical issues included challenges with Wi-Fi connectivity, delays in data uploading; and patient specific factors included overall comfort and management of clinical symptoms [ 24 , 25 ]. Many of these barriers were addressable by training of research staff, reiterating real-time communication with our IT and mHealth program support when needed and by consideration of patient comfort when enrolling a patient, with attention to unmet needs (blanket, food, relaying unmet needs to clinical team, etc.).…”

Section: Discussionmentioning

confidence: 99%

“…While the three-day and thirty-day response rates are low, they are not entirely inconsistent with other ED and hospital-based follow-up surveys. One survey of patients admitted with acute traumatic injury found that 19/26 participants completed the survey with a three month follow-up rate of 38% [ 24 ]. Another study evaluating the differences in follow-up participation based on automated survey data collection versus a more labor intensive, high-intensity collection of PROs surrounding more than 5,700 orthopedic surgeries reported a pre-procedure survey completion rate of 86% vs 100%, 3- or 6-month post-operative response rate of 55% vs 84% and 12-month follow-up of 53% vs 83% based on low- versus high-intensity data collection, respectively [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use

Hawk

Malicki

Kinsman

et al. 2021

Addict Sci Clin Pract

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Background The emergency department (ED) offers an important opportunity to identify patients with opioid use disorder (OUD) and initiate treatment. However, post-ED follow-up is challenging, and novel approaches to enhance care transitions are urgently needed. Outcomes following ED visits have traditionally focused on overdose, treatment engagement, and mortality with an absence of patient reported outcomes (PROs), for example patient ability to schedule follow-up OUD treatment appointments or pick up a prescription medication, that may better inform evaluation of treatment pathways and near-term outcomes after acute events. In the context of increasing novel secure mobile health (mHealth) platforms, we explored the feasibility and acceptability of electronically collecting PROs from ED patients with non-medical opioid use to enhance care in the ED and transitions of care. Methods ED patients with non-medical opioid use or opioid overdose who endorsed willingness and ability to complete electronic surveys after discharge were enrolled from a tertiary, urban academic ED. Participants were enrolled in an mHealth platform, shared electronic health records with researchers, and completed electronic surveys of PROs at baseline, three- and thirty-days post discharge from the hospital, including questions about ability to schedule a follow-up appointment, pick up a prescription medication and overdose risk behaviors. Primary outcomes were measures of feasibility and acceptability of electronic PRO collection among ED patients with non-medical opioid use. Results Among 1,808 patients assessed for eligibility between June-December 2019, 101 of 130 (78%) eligible adult patients consented to participate. Ninety-six (95%) of 101 patients completed registration in the mHealth platform, and 77/96 (80%) were successful in sharing their electronic health data. Completion rates for the baseline, three-day and thirty-day surveys were 97% (93/96), 49% (47/96) and 42% (40/96). Implementation challenges included short engagement window during ED visit, limited access to smartphones/computers, insufficient battery life of participant phone to access email and password, forgotten emails and passwords, multi-step verification processes for account set-up, and complaints about hospital care, most of which were effectively addressed by study personnel. Conclusions ED patients with OUD were willing to share electronic health information and PROs, although implementation challenges were common, and more than half of participants were lost-to-follow-up after hospital discharge at 30 days. Efforts to streamline communication and remove barriers to engagement are needed to improve the collection of PROs and pathways of care in ED patients with OUD. Clinical Trial Registration ClinicalTrials.gov (NCT03985163). Date of Registration: June 10, 2019, Retrospectively registered (First enrollment June 8, 2019). https://clinicaltrials.gov/ct2/show/record/NCT03985163

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use

Hawk

Malicki

Kinsman

et al. 2021

Addict Sci Clin Pract

View full text Add to dashboard Cite

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“…Trauma patients have previously been shown to have poor outpatient follow-up following injuries. 15 Therefore, many studies regarding FFs only report data from the index hospitalization, although in reality this may be inaccurate as many complications occur post-discharge. For instance, among patients with mandible fractures, 7% to 29% suffer complications, of which a majority of these complications are malocclusion and have delayed presentations.…”

Section: Discussionmentioning

confidence: 99%

Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center

Christian

Sun

Khoshab

et al. 2021

Craniomaxillofacial Trauma & Reconstruction

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Study Design: Retrospective cohort. Objective: Traumatic facial fractures (FFs) often require specialty consultation with Plastic Surgery (PS) or Otolaryngology (ENT); however, referral patterns are often non-standardized and institution specific. Therefore, we sought to compare management patterns and outcomes between PS and ENT, hypothesizing no difference in operative rates, complications, or mortality. Methods: We performed a retrospective analysis of patients with FFs at a single Level I trauma center from 2014 to 2017. Patients were compared by consulting service: PS vs. ENT. Chi-square and Mann-Whitney-U tests were performed. Results: Of the 755 patients with FFs, 378 were consulted by PS and 377 by ENT. There was no difference in demographic data ( P > 0.05). Patients managed by ENT received a longer mean course of antibiotics (9.4 vs 7.0 days, P = 0.008) and had a lower rate of open reduction internal fixation (ORIF) (9.8% vs. 15.3%, P = 0.017), compared to PS patients. No difference was observed in overall operative rate (15.1% vs. 19.8%), use of computed tomography (CT) imaging (99% vs. 99%), time to surgery (65 vs. 55 hours, P = 0.198), length of stay (LOS) (4 vs. 4 days), 30-day complication rate (10.6% vs. 7.1%), or mortality (4.5% vs. 2.6%) (all P > 0.05). Conclusion: Our study demonstrated similar baseline characteristics, operative rates, complications, and mortality between FFs patients who had consultation by ENT and PS. This supports the practice of allowing both ENT and PS to care for trauma FFs patients, as there appears to be similar standardized care and outcomes. Future studies are needed to evaluate the generalizability of our findings.

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“…Data from PROMIS has been used to improve outcomes in pain patients. The Collaborative Health Outcomes Information Registry (CHOIR), developed by researchers at Stanford University, incorporates PROMIS to help pain clinicians to survey and process patient-reported data from adult and pediatric patients [119][120][121][122][123]. By utilizing a questionnaire from this registry, clinicians are able to identify important physical and psychological risk factors that are predictive of poor pain outcomes [122][123][124][125].…”

Section: Utilizing Patient-reported Outcome Measurements To Tailor Pa...mentioning

confidence: 99%

A Narrative Review on Perioperative Pain Management Strategies in Enhanced Recovery Pathways—The Past, Present and Future

Chen¹,

Chen²,

Xiang³

2021

JCM

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Effective pain management is a key component in the continuum of perioperative care to ensure optimal outcomes for surgical patients. The overutilization of opioids in the past few decades for postoperative pain control has been a major contributor to the current opioid epidemic. Multimodal analgesia (MMA) and enhanced recovery after surgery (ERAS) pathways have been repeatedly shown to significantly improve postoperative outcomes such as pain, function and satisfaction. The current review aims to examine the history of perioperative MMA strategies in ERAS and provide an update with recent evidence. Furthermore, this review details recent advancements in personalized pain medicine. We speculate that the next important step for improving perioperative pain management could be through incorporating these personalized metrics, such as clinical pharmacogenomic testing and patient-reported outcome measurements, into ERAS program.

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Implementation Challenges Using a Novel Method for Collecting Patient-Reported Outcomes After Injury

Cited by 8 publications

References 24 publications

Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use

Feasibility and acceptability of electronic administration of patient reported outcomes using mHealth platform in emergency department patients with non-medical opioid use

Facial Fractures Have Similar Outcomes When Managed by Either Otolaryngology or Plastic Surgery: Encounters From a Single Level I Trauma Center

A Narrative Review on Perioperative Pain Management Strategies in Enhanced Recovery Pathways—The Past, Present and Future

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