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Optimization of Outpatient Surgery at the CHUM Using the LeoMed Telecare Platform

Not Applicable
Completed
Conditions
Quality of Life
Surgery--Complications
Patient Satisfaction
Interventions
Other: Basic LeoMed application
Other: Complete LeoMed application
Registration Number
NCT04948632
Lead Sponsor
Centre hospitalier de l'Université de Montréal (CHUM)
Brief Summary

The main objective of this study is to carry out a medico-economic evaluation of a new platform for outpatient surgical care, by comparing the effectiveness and utility of the deployment of this trajectory on patients and the health system to a control group.

Detailed Description

Outpatient surgery allows the patient to leave the hospital on the day of their surgery and thus avoid complete hospitalization. There are many advantages to this practice. Patients can remain in the comfort of their own home with the support of their family caregivers and the healthcare system can avoid incurring additional hospital costs and redirect these savings to other critical needs. However, despite the advantages of outpatient surgery, the tools and measures currently in place to supervise the preparation before the operation and the follow-up after the operation are suboptimal.

Following surgery, adverse events such as moderate to severe pain, nausea/vomiting, infection and bleeding from the operative site are very rarely sought out and detected by healthcare facilities. However, these are the main causes of readmissions or emergency consultations for patients.

In order to optimize the care offer, the anesthesiology department, the innovation and artificial intelligence center of the CHUM as well as the Quebec telecare platform LeoMed have joined forces in order to offer, through a health application, follow-up and personalized support for patients undergoing outpatient surgery.

The investigators believe that the integration of this platform in the course of care will allow early diagnosis of the main postoperative complications and therefore, prevent calls to the Health-Info line, emergency room returns, as well as readmissions or unscheduled postoperative consultations.

A patient-as-partner approach has been chosen in the initial phase, where 12 patients having had an outpatient surgery less than 6 months ago, will be recruited to test the platform. Another 12 patients, scheduled to undergo an outpatient surgery, will test the optimized support and follow up application. Their feedback will help to correct and/or improve the platform, if necessary.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • Patients over 18 years old undergoing elective outpatient surgery under general or regional anesthesia
  • Internet access for the patient or their caregiver from home
  • Written, oral and spoken comprehension of French or English
Exclusion Criteria
  • Patient's or caregiver's inability to learn and use digital technologies
  • Conversion of outpatient to inpatient hospitalization on the day of surgery
  • Patient's refusal.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Basic LeoMed applicationBasic LeoMed applicationLeoMed application without artificial intelligence
Complete LeoMed applicationComplete LeoMed applicationLeoMed application with integrated artificial intelligence
Primary Outcome Measures
NameTimeMethod
Cost-effectiveness analysis of the LeoMed® telecare platform1 month after the surgery

The cost-effectiveness of the telecare platform deployment will be evaluated by the assessment of direct costs. These costs include unanticipated cancellations of the surgery on the day of surgery, calls at the CHUM local health info line, calls at the Quebec health info line (811), visits to the emergency department, unplanned readmissions or medical visits (family physician or outpatient clinic) for a problem related to the procedure.

Secondary Outcome Measures
NameTimeMethod
Cost-utility analysis of the LeoMed® telecare platformChange between baseline (pre-operative) and 1 month postoperative

The cost-utility analysis of the telecare platform will be evaluated with the improvement of patient's quality of life. The EQ-5D-5L-VAS will be used to assess quality of life. It is a valid questionnaire including five dimensions, each describing a different aspect of health: MOBILITY, SELF-CARE, USUAL ACTIVITIES, PAIN / DISCOMFORT and ANXIETY / DEPRESSION. Patient satisfaction with care services will also be assessed.

Each dimension has five response levels: no problems, slight problems, moderate problems, severe problems, unable to /extreme problems. The respondent is asked to indicate his/her health state by checking the box next to the most appropriate response level for each of the five dimensions.

The VAS portion of the questionnaire EQ-5D-5L-VAS is a scale where patients are asked to indicate their overall health on the day that the questionnaire is completed, 0 = the worst health you can imagine and 100 = the best health you can imagine.

Patient satisfaction1 month after the surgery

Patient satisfaction with care services and the telecare platform will also be assessed and compared between the two groups using a questionnaire.

Trial Locations

Locations (1)

Centre hospitalier de l'Université de Montréal (CHUM)

🇨🇦

Montréal, Quebec, Canada

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