JMIR perioperative medicine最新文献

{"title":"The Psychological Experience of Frontline Perioperative Health Care Staff in Responding to COVID-19: Qualitative Study.","authors":"Toni Withiel,&nbsp;Elizabeth Barson,&nbsp;Irene Ng,&nbsp;Reny Segal,&nbsp;Daryl Lindsay Goulding Williams,&nbsp;Roni Benjamin Krieser,&nbsp;Keat Lee,&nbsp;Paul Mario Mezzavia,&nbsp;Teresa Sindoni,&nbsp;Yinwei Chen,&nbsp;Caroline Anne Fisher","doi":"10.2196/27166","DOIUrl":"10.2196/27166","url":null,"abstract":"<p><strong>Background: </strong>The rapid spread of the novel coronavirus (COVID-19) has presented immeasurable challenges to health care workers who remain at the frontline of the pandemic. A rapidly evolving body of literature has quantitatively demonstrated significant psychological impacts of the pandemic on health care workers. However, little is known about the lived experience of the pandemic for frontline medical staff.</p><p><strong>Objective: </strong>This study aimed to explore the qualitative experience of perioperative staff from a large trauma hospital in Melbourne, Australia.</p><p><strong>Methods: </strong>Inductive thematic analysis using a critical realist approach was used to analyze data from 9 semistructured interviews.</p><p><strong>Results: </strong>Four key themes were identified. Hospital preparedness related to the perceived readiness of the hospital to respond to the pandemic and encompassed key subthemes around communication of policy changes, team leadership, and resource availability. Perceptions of readiness contributed to the perceived psychological impacts of the pandemic, which were highly varied and ranged from anger to anxiety. A number of coping strategies were identified in response to psychological impacts which incorporated both internal and external coping mechanisms. Finally, adaptation with time reflected change and growth over time, and encompassed all other themes.</p><p><strong>Conclusions: </strong>While frontline staff and hospitals have rapidly marshalled a response to managing the virus, relatively less consideration was seen regarding staff mental health in our study. Findings highlight the vulnerability of health care workers in response to the pandemic and reinforce the need for a coordinated approach to managing mental health.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 2","pages":"e27166"},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39282837","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":"Context and Complexity in Telemedicine Evaluation: Work Domain Analysis in a Surgical Setting.","authors":"Hedvig Aminoff,&nbsp;Sebastiaan Meijer","doi":"10.2196/26580","DOIUrl":"https://doi.org/10.2196/26580","url":null,"abstract":"<p><p>Many promising telemedicine innovations fail to be accepted and used over time, and there are longstanding questions about how to best evaluate telemedicine services and other health information technologies. In response to these challenges, there is a growing interest in how to take the sociotechnical complexity of health care into account during design, implementation, and evaluation. This paper discusses the methodological implications of this complexity and how the sociotechnical context holds the key to understanding the effects and outcomes of telemedicine. Examples from a work domain analysis of a surgical setting, where a telemedicine service for remote surgical consultation was to be introduced, are used to show how abstracted functional modeling can provide a structured and rigorous means to analyze and represent the implementation context in complex health care settings.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 2","pages":"e26580"},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39441395","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":"Utilization of the iOS Shortcuts App to Generate a Surgical Logbook Tool: Feasibility Study.","authors":"Daniel Thompson","doi":"10.2196/24644","DOIUrl":"https://doi.org/10.2196/24644","url":null,"abstract":"<p><strong>Background: </strong>Surgical audit is an essential aspect of modern reflective surgical practice and is key to improving surgical outcomes. The surgical logbook is an important method of data collection for both personal and unit audits; however, current electronic data collection tools, especially mobile apps, lack the minimum recommended data fields.</p><p><strong>Objective: </strong>This feasibility study details the creation of a free, effective surgical logbook tool with the iOS Shortcuts app and investigates the time investment required to maintain a surgical logbook with this tool. In addition, we investigate the potential utility of the Shortcuts app in creating medical data collection tools.</p><p><strong>Methods: </strong>Using the iOS Shortcuts app, we created a shortcut \"Operation Note,\" which collects surgical logbook data by using the minimum and extended audit data sets recommended by the Royal Australasian College of Surgeons. We practically assessed the feasibility of the tool, assessing the time requirement for entry, accuracy, and completeness of the entered data.</p><p><strong>Results: </strong>The shortcut collected accurate and useful data for a surgical audit. Data entry took on average 65 seconds per case for the minimum data set, and 135 seconds per case for the extended data set, with a mean difference of 68 seconds (P<.001; 95% CI 61.6-77.7).</p><p><strong>Conclusions: </strong>This feasibility study demonstrates the utility of the iOS Shortcuts app in the creation of a surgical logbook and the time-consuming nature of data collection for surgical audit. Our iOS Operation Note shortcut is a free, rapid, and customizable alternative to currently available logbook apps and offers surgical trainees and consultants a method for recording surgical operations, complications, and demographic data.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e24644"},"PeriodicalIF":0.0,"publicationDate":"2021-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38977961","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":"Short-Term Wearable Sensors for In-Hospital Medical and Surgical Patients: Mixed Methods Analysis of Patient Perspectives.","authors":"Meera Joshi,&nbsp;Stephanie Archer,&nbsp;Abigail Morbi,&nbsp;Sonal Arora,&nbsp;Richard Kwasnicki,&nbsp;Hutan Ashrafian,&nbsp;Sadia Khan,&nbsp;Graham Cooke,&nbsp;Ara Darzi","doi":"10.2196/18836","DOIUrl":"https://doi.org/10.2196/18836","url":null,"abstract":"<p><strong>Background: </strong>Continuous vital sign monitoring using wearable sensors may enable early detection of patient deterioration and sepsis.</p><p><strong>Objective: </strong>This study aimed to explore patient experiences with wearable sensor technology and carry out continuous monitoring through questionnaire and interview studies in an acute hospital setting.</p><p><strong>Methods: </strong>Patients were recruited for a wearable sensor study and were asked to complete a 9-item questionnaire. Patients responses were evaluated using a Likert scale and with continuous variables. A subgroup of surgical patients wearing a Sensium Vital Sign Sensor was invited to participate in semistructured interviews. The Sensium wearable sensor measures the vital signs: heart rate, respiratory rate, and temperature. All interview data were subjected to thematic analysis.</p><p><strong>Results: </strong>Out of a total of 500 patients, 453 (90.6%) completed the questionnaire. Furthermore, 427 (85.4%) patients agreed that the wearable sensor was comfortable, 429 (85.8%) patients agreed to wear the patch again when in hospital, and 398 (79.6%) patients agreed to wear the patch at home. Overall, 12 surgical patients consented to the interviews. Five main themes of interest to patients emerged from the interviews: (1) centralized monitoring, (2) enhanced feelings of patient safety, (3) impact on nursing staff, (4) comfort and usability, and (5) future use and views on technology.</p><p><strong>Conclusions: </strong>Overall, the feedback from patients using wearable monitoring sensors was strongly positive with relatively few concerns raised. Patients felt that the wearable sensors would improve their sense of safety, relieve pressure on health care staff, and serve as a favorable aspect of future health care technology.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e18836"},"PeriodicalIF":0.0,"publicationDate":"2021-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38897660","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":"An Online Calculator to Better Understand the Impact of False-Negative COVID-19 Polymerase Chain Reaction Test Results in the Context of Anesthesia Providers.","authors":"Sean Runnels,&nbsp;John Frederick Pearson,&nbsp;Jon Dean Samuels,&nbsp;Rohan Kirit Panchamia","doi":"10.2196/26316","DOIUrl":"https://doi.org/10.2196/26316","url":null,"abstract":"<p><p>What does the COVID-19 false-negative exposure problem mean in the context of a local anesthesia practice? We present a customizable online calculator designed to quantify and better understand individual and aggregate provider exposure risk.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e26316"},"PeriodicalIF":0.0,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25599301","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":"Relationship Between Mobile Digital Sensor Monitoring and Perioperative Outcomes: Systematic Review.","authors":"Ali Memon,&nbsp;Patrick Lec,&nbsp;Andrew Lenis,&nbsp;Vidit Sharma,&nbsp;Erika Wood,&nbsp;George Schade,&nbsp;Wayne Brisbane","doi":"10.2196/21571","DOIUrl":"https://doi.org/10.2196/21571","url":null,"abstract":"<p><strong>Background: </strong>Monitoring surgical recovery has traditionally been confined to metrics measurable within the hospital and clinic setting. However, commercially available mobile sensors are now capable of extending measurements into a patient's home. As these sensors were developed for nonmedical applications, their clinical role has yet to be established. The aim of this systematic review is to evaluate the relationship between data generated by mobile sensors and postoperative outcomes.</p><p><strong>Objective: </strong>The objective of this study is to describe the current use of mobile sensors in the perioperative setting and the correlation between their data and clinical outcomes.</p><p><strong>Methods: </strong>A systematic search of EMBASE, MEDLINE, and Cochrane Library from inception until April 2019 was performed to identify studies of surgical patients monitored with mobile sensors. Sensors were considered if they collected patient metrics such as step count, temperature, or heart rate. Studies were included if patients underwent major surgery (≥1 inpatient postoperative day), patients were monitored using mobile sensors in the perioperative period, and the study reported postoperative outcomes (ie, complications and hospital readmission). For studies including step count, a pooled analysis of the step count per postoperative day was calculated for the complication and noncomplication cohorts using mean and a random-effects linear model. The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess study quality.</p><p><strong>Results: </strong>From 2209 abstracts, we identified 11 studies for review. Reviewed studies consisted of either prospective observational cohorts (n=10) or randomized controlled trials (n=1). Activity monitors were the most widely used sensors (n=10), with an additional study measuring temperature, respiratory rate, and heart rate (n=1). Low step count was associated with worse postoperative outcomes. A median step count of around 1000 steps per postoperative day was associated with adverse surgical outcomes. Within the studies, there was heterogeneity between the type of surgery and type of reported postoperative outcome.</p><p><strong>Conclusions: </strong>Despite significant heterogeneity in the type of surgery and sensors, low step count was associated with worse postoperative outcomes across surgical specialties. Further studies and standardization are needed to assess the role of mobile sensors in postoperative care, but a threshold of approximately 1000 steps per postoperative day warrants further investigation.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e21571"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7952235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25404254","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":"Expectations of Continuous Vital Signs Monitoring for Recognizing Complications After Esophagectomy: Interview Study Among Nurses and Surgeons.","authors":"Mathilde van Rossum,&nbsp;Jobbe Leenen,&nbsp;Feike Kingma,&nbsp;Martine Breteler,&nbsp;Richard van Hillegersberg,&nbsp;Jelle Ruurda,&nbsp;Ewout Kouwenhoven,&nbsp;Marc van Det,&nbsp;Misha Luyer,&nbsp;Grard Nieuwenhuijzen,&nbsp;Cor Kalkman,&nbsp;Hermie Hermens","doi":"10.2196/22387","DOIUrl":"https://doi.org/10.2196/22387","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing esophagectomy are at serious risk of developing postoperative complications. To support early recognition of clinical deterioration, wireless sensor technologies that enable continuous vital signs monitoring in a ward setting are emerging.</p><p><strong>Objective: </strong>This study explored nurses' and surgeons' expectations of the potential effectiveness and impact of continuous wireless vital signs monitoring in patients admitted to the ward after esophagectomy.</p><p><strong>Methods: </strong>Semistructured interviews were conducted at 3 esophageal cancer centers in the Netherlands. In each center, 2 nurses and 2 surgeons were interviewed regarding their expectations of continuous vital signs monitoring for early recognition of complications after esophagectomy. Historical data of patient characteristics and clinical outcomes were collected in each center and presented to the local participants to support estimations on clinical outcome.</p><p><strong>Results: </strong>The majority of nurses and surgeons expected that continuous vital signs monitoring could contribute to the earlier recognition of deterioration and result in earlier treatment for postoperative complications, although the effective time gain would depend on patient and situational factors. Their expectations regarding the impact of potential earlier diagnosis on clinical outcomes varied. Nevertheless, most caregivers would consider implementing continuous monitoring in the surgical ward to support patient monitoring after esophagectomy.</p><p><strong>Conclusions: </strong>Caregivers expected that wireless vital signs monitoring would provide opportunities for early detection of postoperative complications in patients undergoing esophagectomy admitted to the ward and prevent sequelae under certain circumstances. As the technology matures, clinical outcome studies will be necessary to objectify these expectations and further investigate overall effects on patient outcome.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e22387"},"PeriodicalIF":0.0,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25361783","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":"Hospital Costs and Long-term Survival of Patients Enrolled in an Enhanced Recovery Program for Open Liver Resection: Prospective Randomized Controlled Trial.","authors":"Chris N Jones,&nbsp;Ben L Morrison,&nbsp;Leigh Js Kelliher,&nbsp;Matthew Dickinson,&nbsp;Michael Scott,&nbsp;Claudia Cecconi Ebm,&nbsp;Nariman Karanjia,&nbsp;Nial Quiney","doi":"10.2196/16829","DOIUrl":"https://doi.org/10.2196/16829","url":null,"abstract":"<p><strong>Background: </strong>The clinical benefits of enhanced recovery programs (ERPs) have been extensively researched, but few studies have evaluated their cost-effectiveness. Our ERP for open liver resection is based closely on the guidelines produced by the Enhanced Recovery After Surgery Society (2016). This study follows on from a previous randomized controlled trial. We also undertook a long-term follow-up of the patients enrolled in the original trial alongside an analysis of the associated health economics.</p><p><strong>Objective: </strong>We aimed to undertake a health economic and long-term survival analysis as part of a trial investigating the implementation of an ERP for open liver resection.</p><p><strong>Methods: </strong>The enhanced recovery elements utilized included extra preoperative education, carbohydrate loading, oral nutritional supplements, postresection goal-directed fluid therapy (LiDCOrapid), early mobilization, and physiotherapy (twice a day compared with once per day in the standard care group). A decision-analytic model was used to compare the study endpoints for ERP versus standard care provided to patients undergoing open liver resection. Outcomes obtained included costs per life-years gained. Resource use and costs were estimated from the perspective of the National Health Service of the United Kingdom. A decision tree and Markov model were constructed using results from our earlier trial and augmented by external data from other published clinical trials. Long-term follow-up was also undertaken for up to 5 years after the surgery, and data were analyzed to ascertain if the ERP conferred any benefit on long-term survival.</p><p><strong>Results: </strong>Patients receiving ERP had an average life expectancy of 6.9 years versus 6.1 years in the standard care group. The overall costs were £9538.279 (£1=US $1.60) for ERP and £14,793.05 for standard treatment. This results in a cost-effectiveness ratio of -£6748.33/QALY. Patients receiving ERP required fewer visits to their general practitioner (P=.006) and required lesser help at home with day-to-day activities (P=.04) than patients in the standard care group. Survival was significantly improved at 2 years at 91% (42/46) for patients receiving ERP versus 73% (33/45) for the standard care group (P=.03). There was no statistically significant difference at 5 years after the surgery.</p><p><strong>Conclusions: </strong>ERPs for patients undergoing open liver resection can improve their medium-term survival and are cost-effective for both hospital and community settings.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e16829"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25317986","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":"Swedish Web Version of the Quality of Recovery Scale Adapted for Patients Undergoing Local Anesthesia and Peripheral Nerve Blockade (SwQoR-LA): Prospective Psychometric Evaluation Study.","authors":"Ulrica Nilsson,&nbsp;Karuna Dahlberg,&nbsp;Maria Jaensson","doi":"10.2196/23090","DOIUrl":"https://doi.org/10.2196/23090","url":null,"abstract":"<p><strong>Background: </strong>The frequency and timing of assessing patient symptoms and discomfort during postoperative recovery are goals. Therefore, real-time recovery evaluation has been suggested to identify specific deficits in patient recovery.</p><p><strong>Objective: </strong>This study aimed to psychometrically evaluate the Swedish Web Version of the Quality of Recovery (SwQoR) Scale adapted for patients undergoing local and peripheral nerve block (SwQoR-LA).</p><p><strong>Methods: </strong>This was a secondary analysis of a psychometric evaluation of 107 patients aged ≥18 years undergoing day surgery under local or peripheral nerve block anesthesia at 4 different day surgery departments in Sweden. The SwQoR-LA, available through a mobile app called Recovery Assessment by Phone Points (RAPP), was completed daily on postoperative days 1-7.</p><p><strong>Results: </strong>Some evidence of construct validity was supported, and discriminant validity was found in 7 of 8 items related to general anesthesia. The internal consistency was acceptable (.87-.89), and the split-half reliability was 0.80-0.86. Cohen d effect size was 0.98, and the percentage of change from baseline was 43.4%. No floor nor ceiling effects were found.</p><p><strong>Conclusions: </strong>The SwQoR-LA is valid, reliable, responsive, and clinically feasible for digital real-time recovery assessment of patient recovery to identify specific deficits in patient recovery and detect those patients who might benefit from a timely intervention.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT02492191; https://clinicaltrials.gov/ct2/show/NCT02492191.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.1136/bmjopen-2015-009901.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"4 1","pages":"e23090"},"PeriodicalIF":0.0,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38756147","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":"Wireless Remote Home Monitoring of Vital Signs in Patients Discharged Early After Esophagectomy: Observational Feasibility Study.","authors":"Martine J M Breteler,&nbsp;Lieke Numan,&nbsp;Jelle P Ruurda,&nbsp;Richard van Hillegersberg,&nbsp;Sylvia van der Horst,&nbsp;Daan A J Dohmen,&nbsp;Mathilde C van Rossum,&nbsp;Cor J Kalkman","doi":"10.2196/21705","DOIUrl":"https://doi.org/10.2196/21705","url":null,"abstract":"<p><strong>Background: </strong>Hospital stays after major surgery are shorter than ever before. Although enhanced recovery and early discharge have many benefits, some complications will now first manifest themselves in home settings. Remote patient monitoring with wearable sensors in the first days after hospital discharge may capture clinical deterioration earlier but is largely uncharted territory.</p><p><strong>Objective: </strong>This study aimed to assess the technical feasibility of patients, discharged after esophagectomy, being remotely monitored at home with a wireless patch sensor and the experiences of these patients. In addition, we determined whether observing vital signs with a wireless patch sensor influences clinical decision making.</p><p><strong>Methods: </strong>In an observational feasibility study, vital signs of patients were monitored with a wearable patch sensor (VitalPatch, VitalConnect Inc) during the first 7 days at home after esophagectomy and discharge from hospital. Vital signs trends were shared with the surgical team once a day, and they were asked to check the patient's condition by phone each morning. Patient experiences were evaluated with a questionnaire, and technical feasibility was analyzed on a daily basis as the percentage of data loss and gap durations. In addition, the number of patients for whom a change in clinical decision was made based on the results of remote vital signs monitoring at home was assessed.</p><p><strong>Results: </strong>Patients (N=20) completed 7 days each of home monitoring with the wearable patch sensor. Each of the patients had good recovery at home, and remotely observed vital signs trends did not alter clinical decision making. Patients appreciated that surgeons checked their vital signs daily (mean 4.4/5) and were happy to be called by the surgical team each day (mean 4.5/5). Wearability of the patch was high (mean 4.4/5), and no reports of skin irritation were mentioned. Overall data loss of vital signs measurements at home was 25%; both data loss and gap duration varied considerably among patients.</p><p><strong>Conclusions: </strong>Remote monitoring of vital signs combined with telephone support from the surgical team was feasible and well perceived by all patients. Future studies need to evaluate the impact of home monitoring on patient outcome as well as the cost-effectiveness of this new approach.</p>","PeriodicalId":73557,"journal":{"name":"JMIR perioperative medicine","volume":"3 2","pages":"e21705"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38777056","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}