SMS-Based Follow-Ups to Improve Post-Discharge Surgical Outcomes
| Status: | Recruiting |
|---|---|
| Conditions: | Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/3/2019 |
| Start Date: | June 9, 2017 |
| End Date: | July 2019 |
| Contact: | Rondi B Gelbard, MD |
| Email: | rondi.beth.gelbard@emory.edu |
| Phone: | 404-251-8745 |
The purpose of this study is to determine whether low-cost Short Message Service (SMS)-based
follow-up medication reminders and surveys for surgical site infection (SSI) reporting can
improve outcomes by increasing medication adherence and earlier detection and care of SSI.
This will be a prospective study involving enrollment of patients onto the Memora Health
platform, a web application developed for automating SMS content to patients. Post-operative
patients will be identified by providers and enrolled prior to discharge, after which they
will be followed for 3 months.
Primary endpoints include medication adherence and patient satisfaction with the text
messaging tool. Secondary endpoints include early detection of SSIs, patient satisfaction
with overall post-discharge care and health-related quality of life, and pertinent 30-day
readmissions.
follow-up medication reminders and surveys for surgical site infection (SSI) reporting can
improve outcomes by increasing medication adherence and earlier detection and care of SSI.
This will be a prospective study involving enrollment of patients onto the Memora Health
platform, a web application developed for automating SMS content to patients. Post-operative
patients will be identified by providers and enrolled prior to discharge, after which they
will be followed for 3 months.
Primary endpoints include medication adherence and patient satisfaction with the text
messaging tool. Secondary endpoints include early detection of SSIs, patient satisfaction
with overall post-discharge care and health-related quality of life, and pertinent 30-day
readmissions.
Post-operative follow up with patients is critical to providing high quality and cost
effective care. In the current standard of care, patients receive verbal instructions from
their physician along with discharge paperwork that outlines best practices for self-care.
Unfortunately, difficult instructions can be miscommunicated or be overwhelming, and patients
often leave confused, resulting in poor patient care post-discharge and high 30-day
readmission rates. Medication adherence represents a crucial area for follow-up, as it is a
major determinant of high-quality outcomes for post-operative care. Specifically, over 50% of
patients in the U.S. either forget to or don't correctly take their prescription medications.
Non-adherence causes nearly 10% of all hospital admissions in the U.S. and 125,000 annual
deaths.
In a survey of 10,000 patients, the most common reported reason for missing medications was
forgetfulness (24%), followed by perceived side effects (20%), high drug costs (17%), and
perception that a prescribed medication would have little effect on their disease (14%). The
majority of the factors contributing to non-adherence could therefore be resolved by
longitudinally addressing forgetfulness and misconceptions about medication effectiveness,
options for treatment, and side effects.
An SMS patient engagement case-management platform (Memora Health, Boston, MA) has been
created that enables providers to input a new medication regimen into a web-based, HIPAA
compliant app that then sends text message reminders to the patient to take their medication.
Communication is two-way, therefore not only helping to improve adherence and self-management
for the patient, but also providing care staff with more data on the post-discharge behavior
and care satisfaction of their patients. While the value of SMS-based interventions on health
outcomes is abundant in the literature, there is a paucity of data evaluating the impact of
SMS follow-up on improving surgical outcomes through improved medication adherence and early
detection of SSI. The purpose of this study is to utilize Memora Health, a platform that
leverages mobile messaging as a medium for advancing preventive care, to improve the quality
of post-operative care delivered to patients, and thereby improve patient satisfaction as
well as reducing readmissions.
effective care. In the current standard of care, patients receive verbal instructions from
their physician along with discharge paperwork that outlines best practices for self-care.
Unfortunately, difficult instructions can be miscommunicated or be overwhelming, and patients
often leave confused, resulting in poor patient care post-discharge and high 30-day
readmission rates. Medication adherence represents a crucial area for follow-up, as it is a
major determinant of high-quality outcomes for post-operative care. Specifically, over 50% of
patients in the U.S. either forget to or don't correctly take their prescription medications.
Non-adherence causes nearly 10% of all hospital admissions in the U.S. and 125,000 annual
deaths.
In a survey of 10,000 patients, the most common reported reason for missing medications was
forgetfulness (24%), followed by perceived side effects (20%), high drug costs (17%), and
perception that a prescribed medication would have little effect on their disease (14%). The
majority of the factors contributing to non-adherence could therefore be resolved by
longitudinally addressing forgetfulness and misconceptions about medication effectiveness,
options for treatment, and side effects.
An SMS patient engagement case-management platform (Memora Health, Boston, MA) has been
created that enables providers to input a new medication regimen into a web-based, HIPAA
compliant app that then sends text message reminders to the patient to take their medication.
Communication is two-way, therefore not only helping to improve adherence and self-management
for the patient, but also providing care staff with more data on the post-discharge behavior
and care satisfaction of their patients. While the value of SMS-based interventions on health
outcomes is abundant in the literature, there is a paucity of data evaluating the impact of
SMS follow-up on improving surgical outcomes through improved medication adherence and early
detection of SSI. The purpose of this study is to utilize Memora Health, a platform that
leverages mobile messaging as a medium for advancing preventive care, to improve the quality
of post-operative care delivered to patients, and thereby improve patient satisfaction as
well as reducing readmissions.
Inclusion Criteria:
- Patient has a working cell phone that can send and receive SMS/Multimedia Messaging
Service (MMS) over the next three months
- Patient has a working cell phone with a camera
- Being able to read and write fluently in English
- All patients identified in the Electronic Medical Record (EMR) with International
Classification of Diseases (ICD)-10 codes for patients who underwent procedures with
external wounds and can be at risk of surgical site infection (SSI). Only patients
falling under the categories of 'Major Diagnostic' and 'Major Therapeutic' will be
considered.
Exclusion Criteria:
- Patient deceased prior to discharge
- Patient transferred to another hospital
- Patient has a terminal illness with less than 3-month expected survival
- Vulnerable populations including patients who are in the middle of a pregnancy or
prisoners
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