V41: Electronic Patient Symptom Reporting System After Hepatopancreatobiliary Surgery

Following hepato-pancreato-biliary (HPB) surgery, patients may experience post-operative symptoms after hospital discharge. Duration and severity of these symptoms during recovery remain unclear. We developed a remote symptom monitoring platform, Recovery Tracker, (RT) to better monitor and characterize patient recovery after HPB surgery.


Methods:

RT is a brief electronic survey sent daily to patients for 10 days post-discharge to assess post-operative symptoms. HPB-specific content was developed with input from a multidisciplinary team of physicians, nurses, administrators, and patients. RT evaluated 16 total symptom domains such as pain, nausea, vomiting, constipation, diarrhea, fatigue, fever, surgical site swelling, and drainage.  Presence and severity of symptoms were reported on a 5-point Likert scale. Automated alerts were generated when moderate or higher severity symptoms were reported; moderate severity prompted “yellow alerts” notifying the outpatient nurse to contact patients in a timely manner, whereas severe/very severe symptoms prompted “red alerts”, notifying both the clinic nurse and patient to communicate urgently. RT was introduced to patients at their appointment prior to surgery and reinforced during discharge and a phone call within 48 hours post-discharge to promote compliance. Responders were defined as patients who completed at least one survey. Refinement of content and response thresholds is ongoing.


Results:

RT was implemented in 4/2021. To date: 478 patients were enrolled and offered RT surveys, of which 345 (72%) were responders. Among responders, the median number of surveys answered was 5 (mean 4.9) out of 10, and each survey took a median of 1 minute to complete. Of the total surveys completed, 25% generated a yellow (20%) or red (5%) alert. Pain was the most common cause for alert (red, 1%; yellow, 16%), followed by constipation (yellow, 10%; Figure).


Conclusions:

RT enables close post discharge monitoring of patients after HPB procedures. Preliminary results indicate that RT has good compliance among patients after HPB surgery. Future research will assess if remote symptom monitoring can prevent unplanned hospital visits or delayed interventions.