Improving outcomes in robot-assisted urologic oncology surgery using a perioperative electronic health program.

Background: Robotic surgery has demonstrated its ability to improve perioperative outcomes thanks to a minimally invasive approach. In addition, the implementation of a perioperative optimized pathway, including eHealth programs, may provide a synergistic effect and help facilitate recovery and reduce complications. The purpose of this study is to evaluate the impact of the BETTY COACHING program on the 90-day complication rate following robot-assisted oncologic urologic surgery.

Methods: We conducted a study to evaluate the impact of the BETTY COACHING program, an app-based, multi-level perioperative digital pathway, on the 90-day complication rate following robot-assisted onco-urologic surgery. Patients were divided into two groups: one benefiting from our coaching program and the other receiving standard care without digital support. Data were analyzed from a prospectively maintained, multicenter registry. Secondary endpoints included hospital stay, readmission, number of days out of hospital, prolonged care at discharge, unplanned visits, and patient satisfaction.

Results: A total of 196 consecutive patients undergoing radical prostatectomy, partial nephrectomy, or radical cystectomy were included in the analysis, with 98 patients in each group. Patients who followed our coaching program experienced significantly fewer post-operative complications [26.5% vs. 9.2%; odds ratios (OR) 0.28; P=0.002] compared to those in the standard care group. The digital program was also associated with a significant reduction in unplanned visits (OR 0.08; P=0.003), readmission rates (OR 0.23; P=0.02), and prolonged care after discharge (OR 0.21; P=0.004). Additionally, patients in the coaching program group had a higher number of days out of the hospital within 90 days post-surgery (89.1 vs. 87.5 days; P=0.002) and reported greater satisfaction (9.1 vs. 7.7/10; P=0.02).

Conclusions: The addition of a digital optimized perioperative program improves 90-day outcomes after robot-assisted onco-urologic surgical procedures in terms of complications, readmission, prolonged care, and patient experience.