Post-surgery patients monitored virtually do better than those seeing doctors in person, study indicates

Patients who underwent non-elective surgery and used technology for regular remote monitoring sessions with health-care providers had better outcomes a month after their release from hospital compared to people who were asked to go see their doctors for followup concerns, a new Canadian study has found.

Researchers from McMaster University in Hamilton followed 905 post-surgery patients from eight different hospitals in Ontario and Alberta for 30 days.

Of those, 451 were monitored remotely using a tablet computer provided to them to connect with a nurse daily for the first 15 days and then every other day for the remainder of the 30 days. Other items, like blood pressure cuffs and heart rate monitors, were connected to the tablet to measure blood pressure, heart rate, respiratory rate, oxygen saturation, temperature and body weight.

The other 454 were given the standard care — meaning they were told to see their doctor in a month or see their doctor if they had any problems.

The study monitored patients who were over age 40, with participants averaging age 63. It was completed during the early stages of the COVID-19 pandemic, between April and July 2020, and published in the British Medical Journal in September.

Dr. Philip J. Devereaux was one of the researchers. He's a cardiologist, clinical epidemiologist and perioperative-care physician at Hamilton Health Sciences, and is also the Salim Yusuf Chair in cardiology at McMaster University.

Devereaux said the regular monitoring of patients helped fix any problems they had very quickly and within minutes, compared to patients waiting to make an appointment or going to a hospital's emergency department. That regular monitoring was made easier by using technology to connect with patients.

For example, the study found 30 per cent of people who were remotely monitored reported having medication errors detected, compared to six per cent of individuals who received traditional care.

"By using our intervention, we were able to correct those drug errors and have a dramatic impact," said Dr. Philip J. Devereaux, one of the researchers, who is a cardiologist, clinical epidemiologist, and perioperative-care physician at Hamilton Health Sciences. He's also the Salim Yusuf Chair in cardiology at McMaster University.

The study was funded through an innovation challenge application grant from pharmaceutical company Roche Canada as well as research grants from McMaster University, the Research Institute of St. Joseph's Healthcare Hamilton, the Ottawa Hospital Academic Medical Association and the Queen's University Department of Anaesthesiology and Department of Medicine Research, as well as in-kind support from the eight hospitals involved.

Cloud DX, a Kitchener-based tech company that created the software that monitored the patients, provided the tablets and data for the tablets used in the study at a discount and trained the medical professionals who took part. 

The study also found people who experienced pain had it addressed more quickly than the patients who received standard care.

Devereaux said many patients believe they have to live with pain, but the remote monitoring allowed nurses or doctors to advise patients on how to alleviate any discomfort they may be experiencing.

"We did it through a very simple intervention that is very low risk to patients, by increasing the use of acetaminophen, which is Tylenol. So we showed that there's a safe way to dramatically decrease pain and moderate to severe pain is a very common and significant issue for patients after surgery."