JMIR Publications

ABSTRACT

Background:

Digital technology and gamified applications (apps) can be useful in the healthcare context. The Enhanced Recovery After Surgery (ERAS) protocol is a way of multimodal perioperative assistance designed to achieve early recovery of patients undergoing surgery.

Objective:

The objective of this study is to describe the development and validation of MobERAS, a gamified mobile health app for the telemonitoring of patients in the postoperative period based on the Enhanced Recovery After Surgery (ERAS) protocol. To evaluate its functionality and usability, the experience of patients, healthcare and computer professionals with its use, and to analyze the data obtained by the app.

Methods:

The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return of intestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a global positioning system that monitors the patient’s walking time and distance and is connected to a virtual database that stores the collected data.

Results:

Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2  7.4 years (ranging from 18 to 85 years). The time of use ranged from 23.4 to 70 hours (meanSD: 45.119.2 hours). Regarding the adherence to the use of MobERAS, the fill rate was 56.3  12.1% (ranging from 41.7 to 100 %) and ambulation data were obtained in 60/65 patients (92.3%). The researcher had access to the data filled out by the patient in real time. There was a good acceptance of the use of MobERAS by the patients, with a good evaluation of the app's usability. The MobERAS app was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health professionals (n= 20) and professionals specializing in technological innovation (n= 10).

Conclusions:

The MobERAS proved to be easy to use, safe, well accepted by patients and well evaluated by experts. Its use can be of great use in clinical surgical practice and an important tool for a greater engagement of patients and health professionals with the ERAS program.