JMIR perioperative medicine最新文献

{"title":"Evaluation of Telemedicine Use for Anesthesiology Pain Division: Retrospective, Observational Case Series Study.","authors":"Laleh Jalilian,&nbsp;Irene Wu,&nbsp;Jakun Ing,&nbsp;Xuezhi Dong,&nbsp;Joshua Sadik,&nbsp;George Pan,&nbsp;Heather Hitson,&nbsp;Erin Thomas,&nbsp;Tristan Grogan,&nbsp;Michael Simkovic,&nbsp;Nirav Kamdar","doi":"10.2196/33926","DOIUrl":"https://doi.org/10.2196/33926","url":null,"abstract":"<p><strong>Background: </strong>An increasing number of patients require outpatient and interventional pain management. To help meet the rising demand for anesthesia pain subspecialty care in rural and metropolitan areas, health care providers have used telemedicine for pain management of both interventional patients and those with chronic pain.</p><p><strong>Objective: </strong>In this study, we aimed to describe the implementation of a telemedicine program for pain management in an academic pain division in a large metropolitan area. We also aimed to estimate patient cost savings from telemedicine, before and after the California COVID-19 \"Safer at Home\" directive, and to estimate patient satisfaction with telemedicine for pain management care.</p><p><strong>Methods: </strong>This was a retrospective, observational case series study of telemedicine use in a pain division at an urban academic medical center. From August 2019 to June 2020, we evaluated 1398 patients and conducted 2948 video visits for remote pain management care. We used the publicly available Internal Revenue Service's Statistics of Income data to estimate hourly earnings by zip code in order to estimate patient cost savings. We estimated median travel time and travel distance with Google Maps' Distance Matrix application programming interface, direct cost of travel with median value for regular fuel cost in California, and time-based opportunity savings from estimated hourly earnings and round-trip time. We reported patient satisfaction scores derived from a postvisit satisfaction survey containing questions with responses on a 5-point Likert scale.</p><p><strong>Results: </strong>Patients who attended telemedicine visits avoided an estimated median round-trip driving distance of 26 miles and a median travel time of 69 minutes during afternoon traffic conditions. Within the sample, their median hourly earnings were US $28 (IQR US $21-$39) per hour. Patients saved a median of US $22 on gas and parking and a median total of US $52 (IQR US $36-$75) per telemedicine visit based on estimated hourly earnings and travel time. Patients who were evaluated serially with telemedicine for medication management saved a median of US $156 over a median of 3 visits. A total of 91.4% (286/313) of patients surveyed were satisfied with their telemedicine experience.</p><p><strong>Conclusions: </strong>Telemedicine use for pain management reduced travel distance, travel time, and travel and time-based opportunity costs for patients with pain. We achieved the successful implementation of telemedicine across a pain division in an urban academic medical center with high patient satisfaction and patient cost savings.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":"e33926"},"PeriodicalIF":0.0,"publicationDate":"2022-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9049645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39906143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Cognitive Demands, Skills, and Assessment Approaches for Endotracheal Intubation: Cognitive Task Analysis.","authors":"Taylor Kunkes, Basiel Makled, Jack Norfleet, Steven Schwaitzberg, Lora Cavuoto","doi":"10.2196/34522","DOIUrl":"10.2196/34522","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proper airway management is an essential skill for hospital personnel and rescue services to learn, as it is a priority for the care of patients who are critically ill. It is essential that providers be properly trained and competent in performing endotracheal intubation (ETI), a widely used technique for airway management. Several metrics have been created to measure competence in the ETI procedure. However, there is still a need to improve ETI training and evaluation, including a focus on collaborative research across medical specialties, to establish greater competence-based training and assessments. Training and evaluating ETI should also incorporate modern, evidence-based procedural training methodologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to use the cognitive task analysis (CTA) framework to identify the cognitive demands and skills needed to proficiently perform a task, elucidate differences between novice and expert performance, and provide an understanding of the workload associated with a task. The CTA framework was applied to ETI to capture a broad view of task and training requirements from the perspective of multiple medical specialties.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A CTA interview was developed based on previous research into the tasks and evaluation methods of ETI. A total of 6 experts from across multiple medical specialties were interviewed to capture the cognitive skills required to complete this task. Interviews were coded for main themes, subthemes in each category, and differences among specialties. These findings were compiled into a skills tree to identify the training needs and cognitive requirements of each task.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The CTA revealed that consistency in equipment setup and planning, through talk or think-aloud methods, is critical to successfully mastering ETI. These factors allow the providers to avoid errors due to patient characteristics and environmental factors. Variation among specialties derived primarily from the environment in which ETI is performed, subsequent treatment plans, and available resources. Anesthesiology typically represented the most ideal cases with a large potential for training, whereas paramedics faced the greatest number of constraints based on the environment and available equipment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Although the skills tree cannot perfectly capture the complexity and detail of all potential cases, it provided insight into the nuanced skills and training techniques used to prepare novices for the variability they may find in practice. Importantly, the CTA identified ways in which challenges faced by novices may be overcome and how this training can be applied to future cases. By making these implicit skills and points of variation explicit, they can be better translated into teachable details. These findings are consistent with previous studies looking at developing improved assessment metrics for","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"5 1","pages":"e34522"},"PeriodicalIF":0.0,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9073620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42357084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Electronic Consultations in Outpatient Surgery Clinics: Synthesized Narrative Review.","authors":"Thomas Payne, Jasmina Kevric, Wanda Stelmach, Henry To","doi":"10.2196/34661","DOIUrl":"10.2196/34661","url":null,"abstract":"<p><strong>Background: </strong>Electronic consultations (eConsults) are an increasingly used form of telemedicine that allows a nonspecialist clinician to seek specialist advice remotely without direct patient-specialist communication. Surgical clinics may see benefits from such forms of communication but face challenges with the need for intervention planning.</p><p><strong>Objective: </strong>We aimed to use the Quadruple Aim Framework to integrate published knowledge of surgical outpatient eConsults with regard to efficacy, safety, limitations, and evolving use in the era of COVID-19.</p><p><strong>Methods: </strong>We systematically searched for relevant studies across four databases (Ovid MEDLINE, Embase, Scopus, and Web of Science) on November 4, 2021, with the following inclusion criteria: English language, published in the past 10 years, and data on the outcomes of outpatient surgical eConsults.</p><p><strong>Results: </strong>A total of 363 studies were screened for eligibility, of which 33 (9.1%) were included. Most of the included studies were from the United States (23/33, 70%) and Canada (7/33, 21%), with a predominant multidisciplinary focus (9/33, 27%). Most were retrospective audits (16/33, 48%), with 15% (5/33) of the studies having a prospective component.</p><p><strong>Conclusions: </strong>The surgical eConsult studies indicated a possible benefit for population health, promising safety results, enhanced patient and clinician experience, and cost savings compared with the traditional face-to-face surgical referral pathway. Their use appeared to be more favorable in some surgical subspecialties, and the overall efficacy was similar to that of medical subspecialties. Limited data on their long-term safety and use during the COVID-19 pandemic were identified, and this should be the focus of future research.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":"e34661"},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9052035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49591738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Canadian Weekend Elective Pediatric Surgery Program to Reduce the COVID-19-Related Backlog: Operating Room Ramp-Up After COVID-19 Lockdown Ends-Extra Lists (ORRACLE-Xtra) Implementation Study.","authors":"Clyde Matava,&nbsp;Jeannette So,&nbsp;R J Williams,&nbsp;Simon Kelley","doi":"10.2196/35584","DOIUrl":"https://doi.org/10.2196/35584","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic caused by the SARS-COV-2 virus has resulted in unprecedented challenges for the health care system. A decrease of surgical services led to substantial backlogs for time-sensitive scheduled pediatric patients. We designed and implemented a novel pilot weekend surgical quality improvement project called Operating Room Ramp-Up After COVID Lockdown Ends-Extra Lists (ORRACLE-Xtra).</p><p><strong>Objective: </strong>Our overall goals are to increase patient access to surgery (and reduce the wait list), improve operating room efficiencies, and optimize parent and staff experience.</p><p><strong>Methods: </strong>Using the DMAIC (define, measure, analyze, improve, control) framework, we implemented ORRACLE-Xtra in a tertiary care academic pediatric hospital during a quiescent period of the COVID-19 pandemic. We defined process and outcome measures based on provincial targets of out-of-window cases. Parental and staff satisfaction was tracked by surveys.</p><p><strong>Results: </strong>ORRACLE-Xtra led to 247 patients receiving surgery during the pilot period, resulting in a 5% decrease in the total number of patients on our wait list with Paediatric Canadian Access Targets for Surgery IV (147/247, 59.5%), with 38.1% (94/247) out-of-window of provincial targets. Most of the process and outcome measures were met or exceeded. Overall parental satisfaction was at 95.8% (110/121), with 79% (64/81) of staff reporting satisfaction with working weekends.</p><p><strong>Conclusions: </strong>Through the ORRACLE-Xtra pilot program, we have shown that hospitals impacted by COVID-19 can reduce the surgical backlog using innovative models of service delivery in a Canadian context. Sustained funding is critical to achieving more meaningful reductions in wait times for scheduled surgeries over the longer term and needs to be balanced with staff well-being.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":"e35584"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8929408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39821948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Case for the Anesthesiologist-Informaticist","authors":"Robert Lee, J. Hitt, G. Hobika, N. Nader","doi":"10.2196/32738","DOIUrl":"https://doi.org/10.2196/32738","url":null,"abstract":"Health care has been transformed by computerization, and the use of electronic health record systems has become widespread. Anesthesia information management systems are commonly used in the operating room to maintain records of anesthetic care delivery. The perioperative environment and the practice of anesthesia generate a large volume of data that may be reused to support clinical decision-making, research, and process improvement. Anesthesiologists trained in clinical informatics, referred to as informaticists or informaticians, may help implement and optimize anesthesia information management systems. They may also participate in clinical research, management of information systems, and quality improvement in the operating room or throughout a health care system. Here, we describe the specialty of clinical informatics, how anesthesiologists may obtain training in clinical informatics, and the considerations particular to the subspecialty of anesthesia informatics. Management of perioperative information systems, implementation of computerized clinical decision support systems in the perioperative environment, the role of virtual visits and remote monitoring, perioperative informatics research, perioperative process improvement, leadership, and change management are described from the perspective of the anesthesiologist-informaticist.","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41451939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Impacts of a Digital Preoperative Assessment Service on Appointments, Travel-Related Carbon Dioxide Emissions, and User Experience: Case Study.","authors":"Madison Milne-Ives, John Leyden, Inocencio Maramba, Arunangsu Chatterjee, Edward Meinert","doi":"10.2196/28612","DOIUrl":"10.2196/28612","url":null,"abstract":"<p><strong>Background: </strong>The National Health Service (NHS) cannot keep up with the demand for operations and procedures. Preoperative assessments can be conducted on the internet to improve efficiency and reduce wait times for operations. MyPreOp is a cloud-based platform where patients can complete preoperative questionnaires. These are reviewed by a nurse who determines whether they need a subsequent face-to-face appointment.</p><p><strong>Objective: </strong>The primary objective of this study is to describe the potential impact of MyPreOp (Ultramed Ltd) on the number of face-to-face appointments. The secondary objectives are to examine the time spent on preoperative assessments completed using MyPreOp in NHS Trusts and user ratings of usability and acceptability.</p><p><strong>Methods: </strong>The study design was a case study service evaluation. Data were collected using the MyPreOp system from 2 NHS Trusts (Guy's and St Thomas' and Royal United Hospitals Bath) and the private BMI Bath Clinic during the 4-month period from September to December 2020. Participants were adults of any age and health status at the participating hospitals who used MyPreOp to complete a preoperative assessment before a scheduled surgery. The primary outcome was the number of face-to-face appointments avoided by patients who used MyPreOp. The investigated secondary outcomes included the length of time spent by nurses completing preoperative assessments, associated travel-related carbon dioxide emissions compared with standard care, and quantitative user feedback. User feedback was assessed at all 3 sites; however, the other outcomes could only be examined in the Royal United Hospitals Bath sample because of data limitations.</p><p><strong>Results: </strong>Data from 2500 participants were included. Half of the assessed patients did not need a further face-to-face appointment and required a median of only 5.3 minutes of nurses' time to review. The reduction in appointments was associated with a small saving of carbon dioxide equivalent emissions (9.05 tons). Patient feedback was generally positive: 79.8% (317/397) of respondents rated MyPreOp as easy or very easy to use, and 85.2% (340/399) thought the overall experience was good or very good.</p><p><strong>Conclusions: </strong>This evaluation demonstrates the potential benefits of MyPreOp. However, further research using rigorous scientific methodology and a larger sample of NHS Trusts and users is needed to provide strong evidence of MyPreOp's efficacy, usability, and cost-effectiveness.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":"e28612"},"PeriodicalIF":0.0,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demonstration and Performance Evaluation of Two Novel Algorithms to Remove Artifacts from Automated Intraoperative Temperature Datasets. (Preprint)","authors":"Amit Bardia, R. Deshpande, G. Michel, D. Yanez, F. Dai, N. Pace, K. Schuster, M. Mathis, S. Kheterpal, R. Schonberger","doi":"10.2196/preprints.37174","DOIUrl":"https://doi.org/10.2196/preprints.37174","url":null,"abstract":"\u0000 BACKGROUND\u0000 Automated acquisition of intraoperative patient temperature data by temperature probes leads to the possibility of incurring a number of artifacts related to probe positioning that may impact their utility for observational research.\u0000 \u0000 \u0000 OBJECTIVE\u0000 We sought to compare the performance of two de-novo algorithms to filter such artifacts.\u0000 \u0000 \u0000 METHODS\u0000 In this observational retrospective study intraoperative temperature data of adults who received general anesthesia for non-cardiac surgery were extracted from the Multicenter Perioperative Outcomes Group (MPOG) registry. Two algorithms were developed and were then compared to the reference standard of anesthesiologists’ manual artifact detection. Sensitivity and specificity for artifact detection were calculated for each algorithm, as were mean temperatures and Area Under the Curve (AUC) for hypothermia (below 36C) for each patient after artifact removal by each methodology.\u0000 \u0000 \u0000 RESULTS\u0000 A total of 27,683 temperature readings from 200 anesthetic records were analyzed. The overall agreement among the anesthesiologists was 92.1%. Both the algorithms had high specificity but moderate sensitivity (Specificity- Algorithm 1: 99.02 % vs. Algorithm 2: 99.54%; Sensitivity- Algorithm 1: 49.13% vs. Algorithm 2: 37.72%, F-score- Algorithm 1: 0.65 vs. Algorithm 2: 0.55). The timeX temperature hypothermic Area Under 36.0 degrees and the mean temperature per case after artifact removal were similar between the algorithms and the anesthesiologists.\u0000 \u0000 \u0000 CONCLUSIONS\u0000 The tested algorithms provide an automated way to filter intraoperative temperature artifacts which closely approximate manual sorting by anesthesiologists.Our study provides evidence demonstrating the efficacy of a highly generalizable artifact reduction algorithm that can be readily employed by observational studies that rely on automated intraoperative data acquisition.\u0000","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44325603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Intraoperative Short Messaging Service Updates: Quality Improvement Initiative to Relieve Caregivers’ Worries","authors":"Alexandre Mignault, Éric Tchouaket Nguemeleu, Stephanie Robins, É. Maillet, E. Matetsa, S. Dupuis","doi":"10.2196/36208","DOIUrl":"https://doi.org/10.2196/36208","url":null,"abstract":"Background Undergoing a surgical procedure is anxiety provoking for patients and their caregivers. During the intraoperative period, caregivers seek out informational updates from health care professionals, a situation complicated by COVID-19 health measures that require caregivers to wait outside the hospital. Short messaging service (SMS)-based communication that allows caregivers to follow their loved ones through surgery has shown promise in relieving anxiety and improving satisfaction with overall care. This form of communication is also well accepted by health care professionals and may be effective at relieving staff burden. Objective Here, we describe a quality improvement initiative of a standardized and integrated intraoperative SMS-based system to improve communication between surgical teams and caregivers. The main goal was to improve satisfaction with care, while the secondary goal was to reduce caregiver anxiety. Methods The initiative followed the framework of the Model for Improvement. A large tertiary care hospital offered the SMS to caregivers who were waiting for loved ones undergoing surgery. SMS messages were integrated into the clinical information system software and sent at key points during the surgical journey to phone numbers provided by caregivers. A satisfaction survey was sent to caregivers 1 business day after surgery. Data were collected between February 16 and July 14, 2021. Results Of the 8129 surgeries scheduled, caregivers waiting for 6149 (75.6%) surgeries agreed to receive SMS messages. A total of 34,129 messages were sent. The satisfaction survey was completed by 2088 (34%) of the 6149 caregivers. Satisfaction with messages was high, with the majority of respondents reporting that the messages received were adequate (1476/2085, 70.8%), clear (1545/2077, 74.4%), informative (1488/2078, 71.6%), and met their needs (1234/2077, 59.4%). The overall satisfaction score was high (4.5 out of 5), and caregivers reported that receiving text messages resulted in a reduction in anxiety (score=8.2 out of 10). Technical errors were reported by 69 (3.3%) caregivers. Suggestions for improvements included having messages sent more often; providing greater patient details, including the patient’s health status; and the service being offered in other languages. Conclusions This digital health initiative provided SMS messages that were systematically sent to caregivers waiting for their loved ones undergoing surgery, just as COVID-19 restrictions began preventing waiting onsite. The messages were used across 15 surgical specialties and have since been implemented hospital-wide. Digital health care innovations have the capacity to improve family-centered communication; what patients and their families find useful and appreciate will ultimately determine their success.","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49012468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Innovative App (ExoDont) for Postoperative Care of Patients After Tooth Extraction: Prototype Development and Testing Study.","authors":"Meenakshi Krishna,&nbsp;Deborah Sybil,&nbsp;Priyanshu Kumar Shrivastava,&nbsp;Shubhangi Premchandani,&nbsp;Himanshu Kumar,&nbsp;Pintu Kumar","doi":"10.2196/31852","DOIUrl":"https://doi.org/10.2196/31852","url":null,"abstract":"<p><strong>Background: </strong>The postoperative period is crucial for the initiation of healing and prevention of complications after any surgical procedure. Due to factors such as poor compliance, comprehension, and retention of instructions, and other unaccounted factors, the objectives of postoperative care are not always achieved. Therefore, an Android-based mobile health app (ExoDont) was developed to ensure a smooth postoperative period for patients after a dental extraction. The ExoDont app delivers reminders for postoperative instructions and drug intake at defined intervals, thus fostering self-reliance among patients in taking their prescribed dose of medication.</p><p><strong>Objective: </strong>The aim of this study is to design, develop, and validate ExoDont, an innovative app for improved adherence to postoperative instructions after tooth extraction.</p><p><strong>Methods: </strong>A postoperative treatment protocol was developed by a team of oral and maxillofacial surgeons and general dentists, following which the clinical and technological requirements of the app were determined along with the software engineers, graphic designers, and applications architect in the team. ExoDont was developed to provide timely reminders for medication and postoperative care. The app was field tested and validated using the User Version of the Mobile Application Rating Scale.</p><p><strong>Results: </strong>The ExoDont software design was divided into a 3-level architecture comprising a user interface application, logical layer, and database layer. The software architecture consists of an Android-based ExoDont app for patients and a web version of the admin panel. The testing and validation of the ExoDont app revealed that Perceived Impact received the highest mean score of all rated components (mean 4.6, SD 0.5), while Engagement received the lowest mean score (mean 3.5, SD 0.8).</p><p><strong>Conclusions: </strong>The testing and validation of the app support its usability and functionality, as well as its impact on users. The ExoDont app has been designed, keeping the welfare of patients in view, in a user-friendly manner that will help patients adhere to the prescribed drug regimen and ensure easy and efficient dissemination of postoperative instructions. It could play an instrumental role in fostering compliance among patients and significantly decrease the complication rate following dental extractions.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 2","pages":"e31852"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8760618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mobile App With Multimodality Prehabilitation Programs for Patients Awaiting Elective Surgery: Development and Usability Study.","authors":"Tianyu Wang,&nbsp;Philip R Stanforth,&nbsp;R Y Declan Fleming,&nbsp;J Stuart Wolf,&nbsp;Dixie Stanforth,&nbsp;Hirofumi Tanaka","doi":"10.2196/32575","DOIUrl":"https://doi.org/10.2196/32575","url":null,"abstract":"<p><strong>Background: </strong>Complying with a prehabilitation program is difficult for patients who will undergo surgery, owing to transportation challenges and a limited intervention time window. Mobile health (mHealth) using smartphone apps has the potential to remove barriers and improve the effectiveness of prehabilitation.</p><p><strong>Objective: </strong>This study aimed to develop a mobile app as a tool for facilitating a multidisciplinary prehabilitation protocol involving blood flow restriction training and sport nutrition supplementation.</p><p><strong>Methods: </strong>The app was developed using \"Appy Pie,\" a noncoding app development platform. The development process included three stages: (1) determination of principles and requirements of the app through prehabilitation research team meetings; (2) app prototype design using the Appy Pie platform; and (3) app evaluation by clinicians and exercise and fitness specialists, technical professionals from Appy Pie, and non-team-member users.</p><p><strong>Results: </strong>We developed a prototype of the app with the core focus on a multidisciplinary prehabilitation program with accessory features to improve engagement and adherence to the mHealth intervention as well as research-focused features to evaluate the effects of the program on frailty status, health-related quality of life, and anxiety level among patients awaiting elective surgery. Evaluations by research members and random users (n=8) were consistently positive.</p><p><strong>Conclusions: </strong>This mobile app has great potential for improving and evaluating the effectiveness of the multidisciplinary prehabilitation intervention in the format of mHealth in future.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 2","pages":"e32575"},"PeriodicalIF":0.0,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39634213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}