Virtual Visits (Utilization of Virtual Care in Postoperative Patients to Improve the Patient Experience)

Not Applicable

Completed

Conditions: Appendectomy, Laparoscopic
Cholecystectomy, Laparoscopic
Cholecystectomy, Robotic

Brief Summary: The purpose of this study is to implement and evaluate postoperative virtual care visits for patients who undergo a laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy. The investigators aim to better understand whether postoperative virtual care visits will not result in a greater composite measure of the occurrence of hospital encounters within Atrium Health (AH) for the 30 days following surgery than standard in-person clinic care. The investigators also aim to better understand whether postoperative virtual care visits provide time and cost savings, and provide equal or improved patient satisfaction and convenience.

Detailed Description: Participants will be randomized to complete either a postoperative follow-up visit using virtual care technology or by attending a standard in-person visit at the clinic. The virtual visit uses a camera-enabled device and internet access to provide live access to the medical professional. Surveys to assess patient satisfaction and convenience will be administered by email on the day of the postoperative follow-up visit. Additional information including demographics, hospital encounters within 30 days of surgery, length of time of the follow-up visit, travel cost and time, whether additional follow-up care is required, and complications after surgery will be collected to evaluate postoperative virtual care visits. Subject participation in the study will end after follow-up care is complete or at 30 days, whichever occurs last.

Recruitment & Eligibility

Inclusion Criteria

Willing to comply with all study procedures and be available for the duration of the study
English speaking
Able to read
Have an email address
Scheduled to undergo a laparoscopic appendectomy, laparoscopic cholecystectomy or robotic cholecystectomy OR have undergone an unplanned (urgent or emergent) laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy
Have surgery performed by a surgeon at either Carolinas Medical Center-Main or Carolinas Medical Center- Mercy who provides emergency general surgery clinical coverage
Live in North Carolina or South Carolina

Exclusion Criteria

Unable to complete a virtual visit (due to lack of appropriate technology, necessary technology skills, other);
Medical condition, laboratory finding, or physical exam finding that precludes participation (patients at high risk for complications, particularly those with perforated appendicitis, patients with active cocaine abuse)
Postoperative length of stay greater than or equal to 4 days
Discharged with drains that need to be removed at a postoperative visit
Admitted from or discharged to assisted living facility, skilled nursing facility, or location other than home
Have chronic pain for which the participant takes narcotic medication

Arm && Interventions

Group	Intervention	Description
Virtual Visit Group	Virtual Visit	Participants assigned to the virtual visit group will receive a virtual visit as their postoperative follow-up visit.

Primary Outcome Measures

Name	Time	Method
Composite measure of the occurrence of hospital encounters	from date of surgery until the date of 30 days after surgery	composite measure of the occurrence of hospital encounters for the 30 days following surgery including all-cause and any-site inpatient, observational, and emergency department visits within Carolinas HealthCare System

Secondary Outcome Measures

Name	Time	Method
Rate of postoperative no-shows	date of follow-up visit, approximately 14 days after date of surgery	percent of scheduled postoperative follow-up appointments in which patients do not complete
Patient travel time to clinic in minutes	date of follow-up visit, approximately 14 days after date of surgery	total patient travel time from home to postoperative follow-up clinic in minutes
Rate of postoperative follow-up	date of follow-up visit, approximately 14 days after date of surgery	percent of patients who receive a postoperative follow-up visit
Patient cost savings in dollars	date of follow-up visit, approximately 14 days after date of surgery	Patient gas cost savings for travel from home to postoperative follow-up clinic
Postoperative follow-up visit time length in minutes	date of follow-up visit, approximately 14 days after date of surgery	total time of postoperative follow-up visit in minutes
Patient satisfaction score	date of follow-up visit, approximately 14 days after date of surgery	self-reported patient satisfaction rating for follow-up visit assessed by survey
Patient convenience score	date of follow-up visit, approximately 14 days after date of surgery	self-reported patient convenience rating for follow-up visit assessed by survey

Locations (1): Atrium Health- Carolinas Medical Center
🇺🇸
Charlotte, North Carolina, United States