Implementation of Recovery Tracker: A Postdischarge Electronic Remote Symptom-Monitoring Survey Tool After Major Urologic Oncology Surgeries.

Abstract

Purpose: Remote symptom monitoring shows promise in promoting postdischarge contact between patients and clinicians. Unique strategies may be needed to tailor reach and engagement to specific patient populations. We aimed to assess implementation and effectiveness outcomes of a patient-reported symptom assessment tool (Recovery Tracker [RT]) after major urologic operations.

Materials and methods: Patients undergoing one of four procedures (2016-2022) at a metropolitan cancer center-radical prostatectomy, nephrectomy, radical cystectomy, and retroperitoneal lymph node dissection for testicular cancer-were included in the study. Electronic delivery of RT was embedded in routine perioperative patient care. Outcomes were assessed according to the reach, effectiveness, adoption, implementation, and maintenance framework. Descriptive statistics was reported for reach, effectiveness, and adoption; a linear mixed-effects model for implementation; and a general additive model and fixed-effects meta-analysis for maintenance.

Results: The cohort comprised 8,934 patients. Reach, defined as patients correctly receiving the survey, was 98% overall, with 81% (95% CI, 80 to 82) of patients completing at least one survey and the majority completing >7. The median time to completion was <2 minutes and improved as patients completed more surveys (P < .001), with slight variation among procedure types. The survey was effective, initiating patient-clinician contact when alert thresholds were triggered, with a marginal increase in the need for clinician office phone calls. Patient engagement with RT was maintained over several years, with a slight improvement after the addition of e-mail reminders (between 3% and 8%).

Conclusion: Implementing a daily electronic survey after hospital discharge after major urologic surgeries is feasible and used often by patients.