Remote Symptom Monitoring in Thoracic Surgery Patients After Discharge.

Abstract

To evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms. Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration. An online symptom-tracking platform for thoracic surgery patients was created on the basis of opinions from stakeholders and a review of the literature. Starting in February 2021, patients were educated about the symptom tracker in preoperative clinics. After discharge, patients received a series of electronic surveys covering 23 symptom domains assessed using a Likert Scale for severity. Moderate symptoms prompted a "yellow alert," and severe symptoms prompted a "red alert," both notifying the nursing team and prompting appropriate action. Patients were considered responders if they completed at least 1 survey. In total, 1997 patients were enrolled; 76% (n = 1520) were responders. Responders were younger, more likely to be White, less likely to have medical comorbidities, and less likely to be readmitted [odds ratio: 0.53 (95% CI: 0.37-0.76); P < 0.001]. Responders who were readmitted had a higher percentage of red alerts (47% vs 24%; P < 0.001) and yellow alerts (74% vs 61%; P = 0.016) compared with responders who were not readmitted. Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.