1. Validation of an m-Health Solution for the Follow-Up ofp Post-operative Patients of Ambulatory Surgery Mara-Jos Nodal ITACA-TSBSpain manodal@itaca.upv.esSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB

2. Problem areaNowadays more complex operations and high risk patients are beingincluded in ambulatory surgery programsAmbulatory Surgery Units manage home post-operative processes thatdemand higher care and more intensive monitoring than usualIts necessary to improve the communication between the AmbulatorySurgery Unit and the patients at homeThe motivation is to offer healthcare quality at home comparable tohospital care without its drawbacksSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 3. MotivationPreliminary study Pilot Group (with m-Health System):Control Group (without m-Health System):61 patients61 patients Results of the preliminary studyIncrease of patient Decrease of costs related to Increase of clinical indicatorssatisfactionpost- operative health careSecond study y Pilot Group (with m-Health System):Control Group (without m-Health System): 156 patients 154 patientsSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010ITACA-TSB 4. Research Objectives Main objecti e in the studyobjectivest d To validate the impact of the use of an m-Health system for them Healthfollow-up of post-operative patients of ambulatory surgeryObjective in the second study To corroborate and validate the results of the preliminary studywith more patients and during a longer period of timeSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 5. Research approach, MethodologyDesign fD i of Sample size Sl iAnalysis A l iClinicalData the sampleand of theindicatorscollectiongrouppathologiesresultsSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010ITACA-TSB 6. Methodology: Design of the sample group Control Group p Pilot Group p Patients from the Patients from theAmbulatory Surgery Unit Ambulatory Surgery Unityg y Patient with any of the Patient with any of thepathologies chosen for thepathologies chosen for thestudy study Usual phone control protocol Usual phone control protocolat home (*SCORE)at home (*SCORE) Patients with m-Healthsystem at home*SCORE: A usual phone control protocol that has been used regularly in theAmbulatory Surgery Unit of the University Hospital Dr. PesetSession 9f: eHealth, 29 October 2010 eChallenges e-2010Copyright 2010 ITACA-TSB 7. Methodology: Design of the sample group Both groups are similar in relation to: Th selection protocolThe l tit l The anesthetic procedure Th surgical procedureThei l d The analgesic protocol The healthcare protocol at home (SCORE)*Session 9f: eHealth, 29 October 2010eChallenges e-2010Copyright 2010 ITACA-TSB 8. Methodology: Sample size and pathologiesSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB 9. Methodology: Sample Sample g pp group Number of patients31040% Male60% FemaleAge range g gUnder 25Older thanyears of65 years of 25-35 36-45 46-55 56-65age ageSession 9f: eHealth, 29 October 2010 eChallenges e-2010Copyright 2010 ITACA-TSB 10. Methodology: m-Health System GPRS/UMTSSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 11. Methodology: Clinical indicatorsClinical indicators Evaluation f h E l i of the patient status by the Si b h Score of the U if h Unit Patient calls to the hospital Number of visits to emergency gy Readmissions Reoperations Changes in the post operative process Chi th tti Staff time used to evaluate the patients progress by phoneSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB 12. Major outcomes and their significanceEvaluation of the patient status by the Score of the Unit N clinical diffNo li i l differences bbetween the groups regarding to: pain, status, oral hdi iltolerance or bleeding Patient calls to the hospital Patient who called to the hospital were only the 9% of the total of the bothgroups of the study No significant differences between the g p g groups The pilot group did not show an increase in the number of callsSession 9f: eHealth, 29 October 2010eChallenges e-2010Copyright 2010 ITACA-TSB 13. Major outcomes and their significanceNumber of visits to emergency, readmissions and reoperations Patient who visited emergency were only the 3.2 % of the total of the both groups of the study The mobile telephone did not decrease significantly the visits to emergency In the study three readmissions have been observed (1%) The variable to use mobile phone has not represented any significant difference in readmissions diff i d i i No reoperation has been registered in none of the 310 patients of the study after a month of evolutionSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 14. Major outcomes and their significanceChanges in the post operative process The pilot group showed one modification on the postoperative evolution (0.7% of the patients with mobile phone)Staff time used to evaluate the patients progress by phone The Pilot Group showed a 44.4% of higher work load in the calls to the patients in comparison to the Control Group p p Due to the patient have to send the photos and the nurse have to evaluate the imagesSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 15. Conclusions The protocol based on m-Health system does not seem to improve the t di d li i l th studied clinical quality i di tlit indicators Control time necessary for the evaluation of the images sent through the mobile phone is 44 4% higher increasing the44.4% higher, dedication time of the phone control staff without clear counterpartsSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 16. Future lines of research The technological solution has been transferred to the company TSB S.A., spin-off of the University TSB S.A. is currently exploring the exploitation viability in y p g py ambulatory surgery, dermatology and plastic surgery Future lines of research are focused in the development of on line questionnaires via web and automated questionnaires with voice recognitionith iitiSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB 17. Mobile photos sent by the patients of the Pilot groupSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB 18. Mobile photos sent by the patients of the Pilot groupSession 9f: eHealth, 29 October 2010 eChallenges e-2010 Copyright 2010 ITACA-TSB 19. Validation of an m-Health Solution for the Follow-Up ofp Post-operative Patients of Ambulatory Surgery Mara-Jos Nodal ITACA-TSBSpain manodal@itaca.upv.esSession 9f: eHealth, 29 October 2010eChallenges e-2010 Copyright 2010 ITACA-TSB