Use and Application of mHealth Technologies in Perioperative Surgical Care: Narrative Review.

Abstract

Background: Surgical procedures and their potential complications place substantial strain on patients, clinicians, and health care systems. These strains are driven by the anticipated morbidity and mortality, so that there is resource-intensive postoperative inpatient management. Given the concentration of surgical services within hospital settings, current standard levels of care have limitations such as communication gaps, time lapses before evaluation, and investment of resources, which limit accessibility and generate disparities in delivery of care. However, recent advances in digital health, including telemedicine platforms, mobile health (mHealth), and wearable technologies, present an opportunity to decentralize and extend perioperative care into community settings. This review explored how established mHealth technologies are being integrated into the perioperative pathway and their impact on surgical care delivery and outcomes. It also highlights possible emerging models of remote physician and patient interaction where benefits seem to be outweighing the risks.

Objective: The aim of this narrative review was to present collected evidence for the use of established mHealth technologies in the surgical pathway of patients and highlight their readiness and potential in models of standard care.

Methods: A comprehensive literature search was conducted across MEDLINE (via PubMed), Web of Science, and Scopus databases between October 2022 and May 2024. Additional sources were identified through reference list screening of relevant systematic reviews. Data were extracted and analyzed based on surgical specialty, type of mHealth intervention, cost-effectiveness, and ethical considerations. Findings were summarized in tables to illustrate key trends and variations across studies. The extracted data were tabulated and described qualitatively to highlight similarities, differences, and possible emerging trends across the studies.

Results: A total of 28 articles published between 2008 and 2022 were included for qualitative analysis, with most (n=21, 75%) originating from the United States, Germany, and the United Kingdom. The study designs were predominantly randomized controlled trials (n=9, 32%) and observational studies (n=8, 29%). Collectively, these studies involved 6344 patients undergoing mHealth-based perioperative interventions primarily in general surgery, orthopedics, and oncology. Interventions frequently used smartphones (n=10, 36%) and wearable devices, often in combination with other tracking and measuring systems. Applications included wound monitoring, postoperative follow-up, and patient education. Data collection was multimodal and typically conducted daily, yet only 36% (10/28) of the articles reported defined follow-up periods. Cost-effectiveness was rarely assessed, with only 4% (1/28) of the articles reporting per-patient savings. Overall, 64% (18/28) of the articles were rated as low quality due to methodological limitations.

Conclusions: mHealth- and telehealth-based interventions show promise in enhancing aspects of perioperative care by enabling remote monitoring, patient engagement, and improved care continuity. Future research should focus on scalable implementation, true cost-effectiveness analysis, equitable access, and integration into clinical workflows to ensure broad applicability in current models of care.