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Improving patient outcomes with a mobile digital health platform for patients undergoing transcatheter aortic valve replacement.
Venkatraman, Vishal; Lad, Shivanand P; Gellad, Ziad F; Heo, Helen; Wu, Kevin A; Dharmapurikar, Rajeev; Liu, Beiyu; Jung, Sin-Ho; Plichta, Ryan; Harrison, J Kevin; Nguyen, Tom C; Doberne, Julie.
Affiliation
  • Venkatraman V; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
  • Lad SP; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
  • Gellad ZF; Higgs Boson Health, Durham, NC, USA.
  • Heo H; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
  • Wu KA; Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.
  • Dharmapurikar R; Higgs Boson Health, Durham, NC, USA.
  • Liu B; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
  • Jung SH; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
  • Plichta R; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
  • Harrison JK; Department of Medicine, Duke University Medical Center, Durham, NC, USA.
  • Nguyen TC; Division of Adult Cardiothoracic Surgery, Department of Surgery, UC San Francisco, San Francisco, CA, USA.
  • Doberne J; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC, USA. Email: julie.doberne@duke.edu.
J Invasive Cardiol ; 35(9)2023 Sep.
Article in En | MEDLINE | ID: mdl-37983113
ABSTRACT

PURPOSE:

ManageMySurgery (MMS) is a digital health application (app) for patients undergoing surgery, including Transcatheter Aortic Valve Replacement (TAVR). Patients using MMS review procedure-specific education, view FAQs, and report patient-reported outcomes. This study assessed the impact of app use on postoperative outcomes.

METHODS:

Patients who underwent TAVR and invited to use MMS between March 2019 and November 2021 were identified. Patients received standard perioperative care and were defined as App users if they signed into the app at least once and engaged with at least one task or FAQ. Demographics and postoperative outcomes were collected via medical record review. Multivariable logistic regression models were used to determine odds of 90-day readmission, Emergency Room (ER) visits, and complications.

RESULTS:

388 patients met inclusion criteria, of which 238 used the app. The average age at surgery was 76.4±7.7 years for users and 78.1±7.6 for non-users. 63.0% of users and 59.3% of non-users were male. App users had significantly lower 90-day readmission rates, (8.8% vs 16.0%, OR=0.51, p=0.0373), ER visit rates (12.6% vs 27.3%, OR=0.36, p=0.0003), and complication rates (Minor 12.2% vs 20.7%, OR=0.48, P=0.0126; Major 8.8% vs. 16%, OR=0.47, P=0.0235).

CONCLUSIONS:

In this non-randomized, retrospective study, we found significant decreases in 90-day readmissions, ER visits, and complications in TAVR patients using an app compared to traditional care. By engaging patients throughout their interventional journey with structured education and tasks, mobile health platforms may mitigate unnecessary use of emergency and inpatient care, thereby improving patient well-being and lowering the burden on healthcare resources.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Telemedicine / Transcatheter Aortic Valve Replacement Limits: Female / Humans / Male Language: En Journal: J Invasive Cardiol Journal subject: CARDIOLOGIA Year: 2023 Document type: Article Affiliation country:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Telemedicine / Transcatheter Aortic Valve Replacement Limits: Female / Humans / Male Language: En Journal: J Invasive Cardiol Journal subject: CARDIOLOGIA Year: 2023 Document type: Article Affiliation country:
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