JMIR Publications

ABSTRACT

Background:

At present, parents lack objective methods to evaluate their child’s postoperative recovery following discharge from the hospital. In result, clinician’s are dependent upon a parent’s subjective assessment of the child’s health status and the child’s ability to communicate their symptoms. This subjective nature of home-monitoring contributes to unnecessary emergency department (ED) utilization as well as delays in treatment. However, the integration of data remotely collected using a consumer wearable device has the potential to provide clinicians with objective metrics for postoperative patients to facilitate informed longitudinal, remote assessment.

Objective:

This multi-institutional study evaluated the impact of adding objective recovery data remotely collected by a consumer wearable device to postoperative telephone encounters on clinicians’ management.

Methods:

Three simulated telephone scenarios of post-appendectomy patients were presented to clinicians at five children’s hospitals. Each scenario was then supplemented with wearable data concerning for or reassuring against a postoperative complication. Clinicians rated their likelihood of ED referral prior to and after the addition of wearable data to evaluate if it changed their recommendation. Clinicians reported confidence in their decision-making.

Results:

Thirty-four clinicians participated. Compared to the scenario alone, the addition of reassuring wearable data resulted in decreased likelihood of ED referral for all three scenarios (p<0.01). When presented with concerning wearable data, there was increased likelihood of ED referral for two of three scenarios (p=0.72, p=0.02, p<0.001). At the institutional level, there was no difference between the five institutions in how the wearable data changed the likelihood of ED referral for all three scenarios. With the addition of wearable data, 76-88% of clinicians reported increased confidence in their recommendations.

Conclusions:

The addition of wearable data to simulated telephone scenarios for post-discharge pediatric surgery patients impacted clinicians’ remote patient management at five pediatric institutions and increased clinician confidence. Wearable devices are capable of providing real-time measures of recovery which can be employed as a post-operative monitoring tool to reduce delays in care and avoidable health care utilization.