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A new study aimed at comparing outcomes of patients receiving postdischarge care that includes telehealth electronic monitoring (THEM) following vascular reconstruction with outcomes of patients receiving standard of care (SOC) is described in the Journal of Vascular Surgery.
Reports of 30-day hospital readmission after vascular surgery range between 11% and 25%. Researchers believe it is reasonable to assume telemonitoring and healthcare management of patients will improve overall health and reduce acute care use by reducing healthcare costs from complications and fewer home visits in rural areas.
Patients scheduled to undergo revascularization procedures with groin incisions will be randomly assigned to receive 4 weeks of telehealth monitoring or SOC. The numbers of 30-day readmissions and surgical site infections (SSIs, including degree of infection) will be recorded, and patients will complete follow-up survey questionnaires.
Telehealth monitoring will be provided by TeleMed 2020, Inc. (Indianapolis, Indiana) in the form of cloud-based software for remote patient monitoring. Registered nurses with >30 years of experience in vascular procedures will be trained in all aspects of the software and equipment for care of the THEM group. The SOC group will receive treatment from care managers. Primary outcomes are 30-day readmissions and deep surgical site infections, and secondary outcomes include pre- and postoperative quality of life measures, superficial SSIs, in-home visits by a nurse, and instances of 30-day stroke, myocardial infarction, or death. This study will be registered at ClinicalTrials.gov (ClinicalTrials.gov Identifier NCT02767011).
Current adherence to the Surgical Care Improvement Project in the United States has not yet demonstrated a direct connection to reduced SSIs, and this study hypothesizes that the use of THEM will reduce SSIs and lead to cost savings and greater patient satisfaction.
Reference
Mousa AY, Broce M, Davis E, McKee B, Yacoub M. Telehealth electronic monitoring to reduce postdischarge complications and surgical site infections after arterial revascularization with groin incision. J Vasc Surg. 2017;66:1902-1908.
