We assessed the feasibility of a mobile application (app) for the remote support and monitoring of patients after discharge from colorectal surgery. In this single centre feasibility study, patients who underwent colorectal surgery were offered a mobile app for use during the first 14 days after discharge from hospital. Patients were asked to submit a daily symptom survey and wound photos as needed. In response, patients received tailored feedback and education through the app. Physician assistants (PA) under surgeons’ supervision reviewed app entries daily, with concerning entries prompting calls to patients to further assess and advise. Feasibility outcomes included app usage by patients, patient satisfaction with the app, and time spent by PAs monitoring the app. Exploratory outcomes included number of calls to patients, emergency room (ER) visits, ER visits avoided, and readmissions. Between November 2016 and April 2017, 106 patients were enrolled in the study. Of these, 92 patients (86.8%) ultimately logged in to and used the app. Eighty-one patients who used the app during the first 14 days at home and had complete data were included in analysis. The mean number of app entries per participant was 7.2 (SD 4.4, range 1 – 14), with highest usage by participants occurring between days 2 to 8 after discharge. Each participant’s responses prompted on average 2.0 call backs (SD 1.9, range 0 – 9) from a PA. Based on app responses, there were 17 prompts to visit the ER. Within 30 days of discharge, 15 participants (18.5%) visited the ER and 5 patients were readmitted. In 3 of the 5 readmissions, visits to ER were avoided, through coordination for patient admission through the mobile app. Satisfaction surveys were completed by 25.3% of patients. All respondents reported their overall experience with the app as good or excellent, and that the app helped them feel more confident in self-management at home. Physician assistants spent on average 1.6 hours per week monitoring the app. This study demonstrated that a mobile app to support of patients at home post-colorectal surgery is a feasible discharge intervention, viewed positively by patients. These findings will inform future larger scale randomized studies to assess the effect of the mobile app on ER visits and readmissions among colorectal surgery patients.

Supporting patients at home after colorectal surgery through a mobile app: A feasibility study