eP292 - Impact of PeriOperative Direct Patient-to-Provider Communication in Colorectal Surgery

Purpose/Background: While telemedicine and its role in post-surgical care has expanded since the COVID epidemic, the extent of its role has been largely limited to video-based clinical encounters to replace in-person clinical visits. In an era of ever-increasing virtual connectedness, providers may be reluctant to use direct patient-to-provider communication applications for medicolegal liability reasons. However, there is an increasing desire and role for these communication options particularly for complex colorectal surgery patients. The objective of this study is to assess the implementation of Twistle, a text application for direct patient to provider communication, during the peri-operative period.Methods/Interventions: We conducted a retrospective, observational study of ambulatory and hospitalized patients who were > 18 years old and underwent elective or urgent resections for both benign and malignant disease between June 2018 to October 2021. Data was collected from a combination of retrospective chart review and patient generated data from the Twistle application. Data included patient demographics, length of stay, surgical treatment provided, and quantity of application encounters. We compared Twistle users to non-users. Analysis included chi square and student t-test, with p < 0.05 considered statistically significant.Results/Outcomes: During our timeframe, 1,995 patients underwent abdominal operations and 1,064 patients enrolled for the Twistle application, while 931 patients opted out. On comparison of the two groups, Twistle users were more likely to be male (51.4% vs 48.1%, p < 0.05) and younger (57.6 vs 59.2 years, p < 0.05). Twistle use was higher at our urban sites compared to our suburban sites (67.7% vs 60.5%, p < 0.05). Twistle users were noted to have a longer average and median length of stay (19.6 vs 10.2days, p < 0.05; 14 vs 7days, p < 0.05). Twistle users were also more likely to have an ostomy, based on reported re-operations for reversal (11.75% vs 7.5%, p < 0.05).Conclusion/

Discussion: Direct patient-to-provider communication applications can be helpful adjuncts in peri-operative care for those interested in their use. Our results indicate a benefit to younger, male patients and to those seeking care in urban centers. Additionally, patients with new ostomies or those who had more prolonged hospitalizations may also benefit from this added means of communication. As telemedicine continues to expand, direct patient to provider communication methods are going to become increasingly important to providing quality care to complex patients.