TY - JOUR
T1 - The Feasibility of a Health Care Application in the Treatment of Patients Undergoing Radical Cystectomy
AU - Metcalf, Meredith
AU - Glazyrine, Vassili
AU - Glavin, Katie
AU - Dahlgren, Alexandra
AU - Michael, Carrie
AU - Bechtel, Misty
AU - Bishop, David
AU - Deruyter, Martin
AU - Mirza, Moben
AU - Taylor, John
AU - Wyre, Hadley W.
AU - Hamilton-Reeves, Jill M.
AU - Holzbeierlein, Jeffrey M.
AU - Lee, Eugene K.
N1 - Publisher Copyright:
© 2019 by American Urological Association Education and Research, Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Purpose:Patients who undergo radical cystectomy of bladder cancer are at high risk for complications and hospital readmissions. Studies indicate insufficient preoperative education and perioperative monitoring. The aim of this study was to demonstrate the feasibility of implementing a health care application to provide more patient education and more thorough monitoring perioperatively.Materials and Methods:Participants with home Wi-Fi access who were undergoing radical cystectomy were recruited for this pilot trial. Each subject was provided a tablet preloaded with the m.Care (LifeScience Technologies, Leawood, Kansas) health care application, an accelerometer and vital sign equipment. Participants were asked to watch educational videos, use the provided accelerometer and perform vital sign monitoring.Results:In 1 year 20 participants enrolled in the study and 15 completed it. The most frequently viewed videos were "Ileal Conduit versus Neobladder" and "Comprehensive Care Pathway." All participants used the accelerometer and 60% kept up with syncing the data regularly. The average step count preoperatively was 5,679 reflecting a sedentary population. Step counts decreased during the inpatient stay (1,351 steps) and trended toward baseline during the postoperative period (3,156 steps). Vital signs were recorded on 85% of assigned days and generated 33 triggers for intervention. While most triggers led to repeat assessment, education and encouragement, 4 participants underwent outpatient treatment, including cultures, intravenous fluids, antibiotics or dronabinol prescription, without the need for hospital readmission.Conclusions:Providing more education and monitoring perioperatively is feasible using a health care application. Testing is warranted to determine the extent to which implementation will improve patient triaging and reduce readmissions.
AB - Purpose:Patients who undergo radical cystectomy of bladder cancer are at high risk for complications and hospital readmissions. Studies indicate insufficient preoperative education and perioperative monitoring. The aim of this study was to demonstrate the feasibility of implementing a health care application to provide more patient education and more thorough monitoring perioperatively.Materials and Methods:Participants with home Wi-Fi access who were undergoing radical cystectomy were recruited for this pilot trial. Each subject was provided a tablet preloaded with the m.Care (LifeScience Technologies, Leawood, Kansas) health care application, an accelerometer and vital sign equipment. Participants were asked to watch educational videos, use the provided accelerometer and perform vital sign monitoring.Results:In 1 year 20 participants enrolled in the study and 15 completed it. The most frequently viewed videos were "Ileal Conduit versus Neobladder" and "Comprehensive Care Pathway." All participants used the accelerometer and 60% kept up with syncing the data regularly. The average step count preoperatively was 5,679 reflecting a sedentary population. Step counts decreased during the inpatient stay (1,351 steps) and trended toward baseline during the postoperative period (3,156 steps). Vital signs were recorded on 85% of assigned days and generated 33 triggers for intervention. While most triggers led to repeat assessment, education and encouragement, 4 participants underwent outpatient treatment, including cultures, intravenous fluids, antibiotics or dronabinol prescription, without the need for hospital readmission.Conclusions:Providing more education and monitoring perioperatively is feasible using a health care application. Testing is warranted to determine the extent to which implementation will improve patient triaging and reduce readmissions.
KW - cystectomy
KW - mobile applications
KW - monitoring
KW - patient education as topic
KW - physiologic
KW - urinary bladder
UR - http://www.scopus.com/inward/record.url?scp=85065092337&partnerID=8YFLogxK
U2 - 10.1097/JU.0000000000000050
DO - 10.1097/JU.0000000000000050
M3 - Article
C2 - 30694938
AN - SCOPUS:85065092337
SN - 0022-5347
VL - 201
SP - 902
EP - 908
JO - Journal of Urology
JF - Journal of Urology
IS - 5
ER -