Evaluation of Mobile Technology Access

Utility of routine postoperative visit after appendectomy and cholecystectomy with evaluation of mobile technology access in an urban safety net population.

(Article published Aug 2014; US National Library of Medicine; National Institute of Health. Learn more: http://www.ncbi.nlm.nih.gov/pubmed/24880202)

Abstract

BACKGROUND:

The value of routine postoperative visits after general surgery remains unclear. The objective of this study was to evaluate the utility of routine postoperative visits after appendectomy and cholecystectomy and to determine access to mobile technology as an alternative platform for follow-up.

METHODS:

Retrospective review of 219 appendectomies and 200 cholecystectomies performed at a safety net hospital. One patient underwent both surgeries. Patient demographics, duration of clinic visit, and need for additional imaging, tests or readmissions were recorded. Access to mobile technology was surveyed by a validated questionnaire.

RESULTS:

Of 418 patients, 84% percent completed a postoperative visit. At follow-up, 58 patients (14%) required 70 interventions, including staple removal (16, 23%), suture removal (4, 6%), drain removal (8, 11%), additional follow-up (20, 28%), medication action (16, 21%), additional imaging (3, 4%), and readmission (1, 1%). Occupational paperwork (62) and nonsurgical clinic referrals (28) were also performed. Average check-in to check-out time was 100 ± 54 min per patient. One intervention was performed for every 7.8 h of time in the clinic. Additionally, 88% of the surveyed population reported access to cell phone technology, and 69% of patients

CONCLUSIONS:

Routine in-person follow-up after surgery consumes significant time and resources for patients and healthcare systems but has little impact on patient care. Most of the work done in the clinic is administrative and could be completed using mobile technology, which is pervasive in our population.

Authors & Contributors

Chen DW1, Davis RW1, Balentine CJ2, Scott AR1, Gao Y1, Tapia NM1, Berger DH2, Suliburk JW3.

  • 1Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
  • 2Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center of Excellence, Houston, Texas.
  • 3Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center of Excellence, Houston, Texas. Electronic address: Suliburk@bcm.edu.