Postoperative Care Using a Secure Online Patient Portal: Changing the (Inter)Face of General Surgery
Postoperative Care Using a Secure Online Patient Portal: Changing the (Inter)Face of General Surgery
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DOI：
10.1016/j.jamcollsurg.2015.08.429
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发表时间：
2015-12-01
影响因子：
5.2
通讯作者：
Poulose, Benjamin K.
中科院分区：
文献类型：
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作者：
Broman, Kristy Kummerow;Oyefule, Omobolanle O.;Poulose, Benjamin K.
背景：许多患者寻求更容易获得医疗保健。与此同时，由于劳动力短缺和绩效要求提高，外科医生面临着越来越多的时间限制。在线术后护理可以改善患者就诊的机会，同时提高外科医生的效率。我们的目的是评估患者和外科医生对择期普外科手术后在线术后护理的接受程度。 研究设计：一项学术普外科服务范围内的一项前瞻性试点研究，比较了 2014 年 5 月至 12 月的在线和现场术后就诊。纳入的患者由 5 名外科医生中的 1 人接受了择期腹腔镜胆囊切除术、腹腔镜腹侧疝修补术、脐疝修补术或腹股沟疝修补术。患者提交症状调查和伤口图片，然后使用在线患者门户与外科医生联系。主要结果是患者报告接受在线就诊而不是亲自就诊。次要结果包括通过在线就诊发现并发症、外科医生报告的有效性和就诊时间。 结果：50 名患者完成了在线和亲自就诊。大多数患者可以接受在线就诊作为唯一的随访（76%）。外科医生表示，对于 68% 的患者来说，两种就诊类型同样有效，而 24% 的患者认为诊所就诊更有效，8% 的患者认为在线就诊更有效。通过在线就诊没有遗漏任何并发症，这显着减少了患者（15 分钟 vs 103 分钟，p < 0.01）和外科医生（5 vs 10 分钟，p < 0.01）的时间。 结论：在该人群中，在线术后就诊被患者和外科医生接受，花费的时间更少，并有效地识别需要进一步护理的患者。需要进一步评估以确定特定人群在线术后就诊的安全性和潜在益处。由爱思唯尔公司代表美国外科医生学会出版。
BACKGROUND: Many patients seek greater accessibility to health care. Meanwhile, surgeons face increasing time constraints due to workforce shortages and elevated performance demands. Online postoperative care may improve patient access while increasing surgeon efficiency. We aimed to evaluate patient and surgeon acceptance of online postoperative care after elective general surgical operations.STUDY DESIGN: A prospective pilot study within an academic general surgery service compared online and inperson postoperative visits from May to December 2014. Included patients underwent elective laparoscopic cholecystectomy, laparoscopic ventral hernia repair, umbilical hernia repair, or inguinal hernia repair by 1 of 5 surgeons. Patients submitted symptom surveys and wound pictures, then corresponded with their surgeons using an online patient portal. The primary outcome was patient-reported acceptance of online visits in lieu of in-person visits. Secondary outcomes included detection of complications via online visits, surgeon-reported effectiveness, and visit times.RESULTS: Fifty patients completed both online and in-person visits. Online visits were acceptable to most patients as their only follow-up (76%). For 68% of patients, surgeons reported that both visit types were equally effective, while clinic visits were more effective in 24% and online visits in 8%. No complications were missed via online visits, which took significantly less time for patients (15 vs 103 minutes, p < 0.01) and surgeons (5 vs 10 minutes, p < 0.01).CONCLUSIONS: In this population, online postoperative visits were accepted by patients and surgeons, took less time, and effectively identified patients who required further care. Further evaluation is needed to establish the safety and potential benefit of online postoperative visits in specific populations. Published by Elsevier Inc. on behalf of the American College of Surgeons.