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ViewAttendees 1

Session: Quick Shots: Quality 1

QS121 - Comparison of Readmission Rates Before and After Implementation of Smartphone-based Symptom Monitoring in Patients Undergoing Elective Colorectal Surgery

Sunday, June 2, 2024
10:57 AM – 11:00 AM ET, USA
Location: Room 327

    Quick Shot Presenter(s)

  • Hans M. Huber, MD

    Resident
    Mount Sinai Hospital/Memorial Sloan Kettering Cancer Center
    Mount Sinai
    New York, New York, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Georgios Karagkounis, MD

    Assistant Attending
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

    Disclosure information not submitted.

  • Maria Widmar, MD, MPH, FACS (she/her/hers)

    Assistant Attending
    Memorial Sloan Kettering Cancer Center
    Weill Cornell Medical Center
    New York, New York, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

  • IW

    Iris Wei, MD

    Surgeon
    Memorial Sloan Kettering Cancer Center
    New York City, New York, United States

    Disclosure information not submitted.

  • J. Joshua Smith, MD, PhD

    Associate Attending
    Memorial Sloan Kettering Cancer Center
    MSKCC, Weill Cornell Medical College
    New York, New York, United States

    Disclosure information not submitted.

  • Garrett M. Nash, MD, MPH

    Vice Chair, Department of Surgery
    Memorial Sloan Kettering
    New York, New York, United States

    Disclosure information not submitted.

  • Martin Weiser, MD

    Attending Surgeon and Professor
    Memorial Sloan Kettering Cancer Center
    Cornell Medical College
    New York, New York, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

  • Philip B. Paty, FASCRS, FACS

    Attending Surgeon, Colorectal Surgery Service
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

    Disclosure information not submitted.

  • Julio Garcia-Aguilar, MD, PhD (he/him/his)

    Chief Attending
    Memorial Sloan Kettering Cancer Center
    Memorial Sloan Kettering Cancer Center
    New York, New York, United States

    Disclosure information not submitted.

  • Emmanouil Pappou, MD, PhD

    Assistant Attending
    Memorial Sloan Kettering Cancer Center
    new York, New York, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: The prevalence of smartphones has afforded an opportunity for remote, technology-based symptom monitoring in the outpatient setting following discharge after a surgical admission. For patients, it is often difficult to discern if postoperative symptoms are serious enough to trigger readmission. Since 2021, our institution has deployed a tool called the Recovery Tracker which consists of a series of web-based surveys that allow patients to report their symptoms to providers during the first 10 days after discharge. The aim of this study is to determine the efficacy of the recovery tracker in terms of helping patients differentiate between symptoms that require admission and those that can be managed at home.

Methods/Interventions: This retrospective observational study at a single, high-volume center examined the role of a post-discharge, patient-controlled symptom monitoring system. All patients undergoing elective colorectal surgery after implementation of the recovery tracker system in March 2021 to December of 2022 were included. The primary outcome was a potentially unnecessary visit to the hospital’s urgent care center (UCC) defined as a UCC visit not requiring inpatient admission. The secondary outcome was overall readmission for the 30 days after discharge.

Results/Outcomes: A total of 1964 unique patients who underwent surgery following recovery tracker implementation met inclusion criteria. 1370 (70%) responded to at least one recovery tracker survey. The remaining 594 did not respond to any surveys and were defined as “non-responders.” The rate of visits to the UCC not requiring admission were similar among responders (4.3%) and non-responders (4.8%). Among responders, the 30-day readmission rate was 9.3%, compared to a rate of 19.0% in non-responders. 1237 patients undergoing inpatient colorectal surgery from the period of February 2019 to February 2020 were studied as a control cohort. These patients were examined to determine the rate of readmission in the year prior to the global COVID-19 pandemic. 88 of these patients (7.1%) were readmitted within 30 days and 20 (1.6%) visited the UCC without requiring admission.

Conclusion/Discussion: Usage of a recovery tracker in this cohort does not demonstrate a significant decrease in the rate of potentially avoidable urgent care visits. A higher response rate to a smartphone-based recovery tracker system may be associated with a lower likelihood of readmission following discharge from inpatient colorectal surgery.