Research: Digital Health Platform Helps Improve Surgical Outcomes

Implementing a digital health tool in combination with a real-life health coach can help patients meet pre-surgical preparation and post-surgical recovery guidelines and improve surgical outcomes, according to research by UPMC physicians and the University of Pittsburgh School of Medicine.

Research published in the Internet medical research journal found that patients who used the digital health platform, called Pip Care, had a reduced length of stay compared to their counterparts who did not use the app, and halved their risk of readmission within a week of surgery.

Pip Care, the first company created from a collaboration between UPMC Enterprises and Redesign Health, was established to help patients prepare for and recover from surgery through a consumer-facing app.

Pip Care focuses on the digitalization and automation of existing processes, workflows and perioperative protocols. The company provides personalized patient health education and counseling to prepare them for surgery and recovery.

“Study after study has shown that patients are healthier and have better surgical outcomes when they follow a perioperative care plan, but ensuring compliance is easier said than done,” said lead author Aman Mahajan, MD, Ph. .D., Peter and Eva Safar, professor and chair of the Department of Anesthesiology and Perioperative Medicine at Pitt, in a statement. “Therefore, verifying that this hybrid digital telemedicine platform is easy to use for patients and physicians and significantly improves patient outcomes and satisfaction with surgery is a welcome clinical advance.”

Mahajan and senior author Stephen Esper, MD, associate professor of anesthesiology and perioperative medicine at Pitt and director of the UPMC Center for Perioperative Care, are clinical advisors to Pip Care, which receives funding from UPMC Enterprises, the innovation, commercialization and risk capital. from UPMC.

Several digital health platforms that use mobile apps to provide perioperative instructions to patients have been implemented in recent years, but researchers noted that results have been mixed. They added that Pip Care is the first to combine the digital platform with personalized telehealth advisors who visit patients regularly and help them coordinate care so they can achieve their surgical goals.

In preparation for elective surgery, doctors often recommend patients follow evidence-based protocols, known as “prehabilitation,” to improve their health. These may include improving your nutrition, fitness, psychological support and stopping smoking. Pip Care helps patients comply with these protocols by simplifying the doctor’s pre-surgical instructions into daily tasks that are easy to understand and complete. The healthcare advisor answers questions and keeps the patient accountable. Finally, Pip Care also simplifies and counsels patients through post-surgical care, such as understanding discharge instructions, wound care and the importance of proper pain management, the company said.

“Think of undergoing major surgery like running a marathon,” Esper said in a statement. “If you want to do your best, don’t just show up and run. You must first train and prepare your body for stress. The same goes for surgery: by optimizing your health beforehand, you will have a better recovery.”

The research team compared 128 patients enrolled in Pip Care who were scheduled for elective abdominal, spine, or total joint replacement surgery with 268 pairs scheduled for the same surgeries at the same hospitals who did not use Pip Care. Patients using Pip Care were enrolled 2.5 to 4 weeks before surgery and continued using it for 4 weeks after surgery.

On average, Pip Care patients remained hospitalized after surgery for 2.4 days, while non-Pip Care patients remained in hospital for 3.1 days. And Pip Care patients had a 49 percent lower risk of being readmitted to the hospital within a week of discharge, compared to their counterparts not using Pip.

Patients who received Pip Care attended an average of 6.7 sessions with their digital health coach and 82 percent attended sessions at least once a week. And, in follow-up surveys, patients reported high scores (4.8 out of 5 points) for satisfaction with the app.

“Many health systems are facing significant staffing shortages, and one consequence is that clinical teams, who are dedicated to the success of their patients, have limited time to deliver focused, patient-specific surgical optimization,” he said. Mahajan, who is also the senior vice president of health innovation at UPMC Enterprises. “By partnering with health systems and hospitals, Pip Care gives patients a sense of connection and a better understanding of their surgical journey, driving them to actively participate in their health and those patients achieving better surgical outcomes.”

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