02.08 Colorectal Surgery Outcomes After Implementation of a Technology-Augmented ERAS Pathway

N. P. Perez1, L. Bordeianou1, R. Ricciardi1, H. Kunitake1, C. Cauley1, J. Conley1, R. A. Hodin1, D. Berger1, J. C. Cusack1, C. E. Stafford1, C. W. Hunt1, G. M. Boland1 1Massachusetts General Hospital,Surgery,Boston, MA, USA


The perioperative journey is complex and difficult to navigate for patients and their families. The purpose of this study was to compare the outcomes after colorectal surgery between patients enrolled in a 1-year pilot of a technology-augmented ERAS pathway compared with historic controls enrolled in a paper-based pathway.


Adult patients undergoing elective colorectal surgery from 6/11/2020–7/9/2020 were included in this study, as part of an ongoing 1-year pilot. Patients were enrolled on a commercially available patient engagement and data collection platform, which allows for the delivery of reminders, surveys, and educational materials created by our institution’s colorectal surgery service via a mobile app, text messages, and/or emails. Surveys delivered include patient-reported outcome (PRO) questionnaires and daily health checks meant to aid in the early detection of complications. The primary outcome was 30-day readmissions compared to historic controls. Secondary outcomes included preoperative anxiety, engagement and satisfaction with the platform. Patient anxiety was measured using the PROMIS-anxiety survey and patient engagement was ascertained by the completion of daily health checks and PRO surveys. Satisfaction with the platform was measured using the system usability scale (SUS) and the net promoter score (NPS).


A total of 40 patients were enrolled on the platform. Their mean age was 53.0 ±16.6 years old, 48.8% were female, 90% were White; 23 (57.5%) patients downloaded the mobile app. Compared to historic controls, patients using the platform had a lower rate of 30-day readmissions (10% vs 19%) and felt less nervous/anxious before surgery (11.4% vs 22.7% often/always). App users opened it an average of 2.9 times per day. Out of 280 daily health checks delivered, 187 (67%) were completed, with 86% of patients completing at least 3 of them. Postoperative PRO collection rates were 67.8% at 1 week, and 50% at 3 weeks, an increase from previous rates of approximately 10% using paper-based surveys. Most patients felt the platform was easy to use (69.2% agree/strongly agree) and its functions were well integrated (76.9% agree/strongly agree), with an overall NPS of 70%.


The addition of a patient engagement and data collection technology platform to aid in the delivery of an existing ERAS pathway appears to have benefitted patient care, both with regards to outcomes as well as patient experience, satisfaction, and PRO collection. We expect the benefits of this technology to become even clearer as our 1-year pilot progresses, and we reach our projected total enrollment of 600 patients (50 additional have been enrolled since 7/9/2020). As mobile technologies become even more widespread and ubiquitous, it is incumbent upon us to adapt the way we deliver care and take advantage of these resources, to ultimately provide our patients with the outcomes and surgical experience they deserve.