S. C. McGriff1, D. Kumar1, P. R. Moolchandani1, M. K. Hoffman2, M. A. Davis2, J. W. Suliburk2 1Baylor College Of Medicine,Houston, TX, USA 2Baylor College Of Medicine,Michael E. DeBakey Department Of Surgery,Houston, TX, USA
Introduction: Studies have found that in-person postoperative care for low risk operations is both costly for patients and system and not always necessary. Using text messages could be an inexpensive, patient-centered, and safe method to screen patients for complications. We conducted a study to determine the feasibility of using an automated text message system as a screening tool for need for in-person postoperative follow-up.
Methods: Patients who underwent a laparoscopic operation for non-complicated appendicitis or cholecystitis were recruited and enrolled into the study on day of discharge. The study population was polled to determine preferences for frequency and time of text messaging. Subjects received text messages tailored for patient-centered screening of warning signs of post-operative complication. If screened positive, the participant’s physician was notified. Participants were asked patient satisfaction questions.
Results: During a 5-month period, 44 patients were screened, 39 patients were enrolled: 24 following cholecystectomy operations and 15 following appendectomy operations; 18 received text messages in English and 21 received text messages in Spanish. 2 participants were readmitted with a complication and both were successfully identified by the automated system. 15% of participants elected to cancel their follow-up appointment. 74% of participants with scheduled follow-up appointments attended their appointment. Participant response rate to text messages for the first 10 days following discharge is summarized in Table 1. Of the participants completing the study, 96% indicated they would use the automated text messages again.
Conclusion: This pilot study has shown that an automated text message system as a screening tool for post-op complication is feasible and safe in a safety-net population. Our system was able to capture progression of relevant symptoms of participants and notify the participant’s physician when warning signs were detected. Furthermore, participants would use the text message system again. Given inconsistent response data, there is opportunity for improvement in patient engagement with the communication system. A larger implementation is warranted to demonstrate clinical utility and cost effectiveness.
