How to Implement Surgical Remote Monitoring: The Top 3 Workflows for Enrolling & Monitoring Patients

In an effort to reduce the surgical backlog caused by the COVID-19 pandemic, many healthcare organizations are seeking innovative technology solutions. An effective Surgical Remote Monitoring platform can lessen the backlog by reducing hospital length of stay, readmissions, ED visits, and by ultimately ensuring patients get the right care outside of the hospital. After assembling an optimal team for your Surgical Remote Monitoring program, it is important to determine how to best engage your staff & patients to maximize the potential of the technology.

“How much time will this take?” is the most common question you will hear from front-line staff. The short answer is “it depends” –  depending on your staff resources and goals, the level of staff involvement can vary – and you may evolve this over time.

Below are the 3 main levels of staff engagement you can choose from, each with its own pros and cons. In short, there is typically a correlation between level of staff engagement and patient satisfaction & clinical outcomes. However, there is no “right” or “wrong” approach – ultimately, the appropriate approach is what works best within the resources and clinical workflows of your team. Note: Depending on resources, teams can use different levels for different activities (e.g. Hands on for patient education, engagement and enrolling + Hands Off for monitoring).

Workflow 1:
Hands Off (Low Touch)
Workflow 2:
Hands On (High Touch)
Workflow 3: Supercharged
(Highest Touch)
Activities
How patients learn about the Surgical Remote Monitoring program
For elective cases: At time of consent in pre-op
For emergent cases: At hospital discharge
Instructional brochureInstructional brochure
Verbal education
Instructional brochure
Verbal education
App demonstration

Time points to educate or reinforce patient engagement with program
Only at patient enrollmentAt multiple phases of care (pre-op and at discharge)At all phases of care (pre-op, in-hospital and at discharge)
How providers use the platform to mitigate real-time riskNone
SeamlessMD is used as a patient self-management program only
1 or 2 care navigators receive all alerts, monitor patients via dashboards and triage/escalate to colleagues as appropriate Alerts and dashboards are customized to specific team members (e.g. wound care nurses alerted for wound issues; diet issues to dietician)
Time commitment

Patient explanation of initiative
30-60 seconds / patient
(Brochures only)
2-3 minutes / patient
(Brochures, verbal)
5-7 minutes / patient
(Brochures, verbal, app demo)

Patient enrollment
(e.g. for enrolling into platform backend, assuming no EHR integration)


30-60 seconds / patient

30-60 seconds / patient

30-60 seconds / patient

Managing alerts and remote monitoring dashboards
None 
Patients only have access to automated self-care guidance
1-2 hours per week
(1-2 nurses managing all alerts)
15-45 mins per week per care team member

(work is more distributed)
Benefits / Return on Investment
↑ Patient satisfaction
↓  LOS
↓  Phone calls
↓  ER visits
↑ Patient satisfaction
↓ LOS
↓ Phone calls
↓ ER visits
↓ Readmissions
↑↑  Patient satisfaction
↓     LOS
↓     Phone calls
↓↓  ER visits
↓↓  Readmissions

*Highest levels of patient engagement due to high staff promotion of initiative

Workflow #1: Hands Off (Low Touch):

Patient explanation: 30-60 seconds / patient (brochures only)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: None

  • • Patients are enrolled into the program at the beginning of their journey (e.g. at consent for surgery) or at discharge (for emergency surgery cases).
  • • Patients learn about the Surgical Remote Monitoring platform through instructional brochures and are educated only at the time of enrollment.
  • • Through the platform, patients have access to 24/7 self-care resources, giving them support through their care transitions (e.g. prehab, pre-op, and post-op recovery). 
  • • If the patient shows a sign of risk, the platform can instruct the patient to take appropriate action (e.g. manage care at home, call the nurse, go to ER, etc.).
  • • This experience is entirely based on patient self-monitoring, and providers are not doing any real-time remote monitoring.
  • • While the hands off approach can have good results for improving patient satisfaction, reducing LOS and reducing phone calls, it has less of an impact on preventing readmissions.


Workflow #2: Hands On (High Touch)

Patient explanation: 2-3 minutes / patient (brochures, verbal)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: 1-2 hours / week (1-2 nurses managing all alerts)

This approach builds on the “hands off” framework, by adding:

  • • More staff verbal education to increase patient engagement. Patient usage of the program is reinforced by team members at all phases of care (pre-op, in-hospital and at discharge).
  • • Staff using clinical alerts and remote monitoring dashboards to intervene sooner for patients at-risk. This also allows the care team to view real-time patient-reported outcomes (e.g. symptoms, incision photos) to help make informed decisions such as whether an immediate follow-up visit is necessary.
  • • This high touch approach generally leads to more patient engagement and further reductions in ER visits and readmissions, as providers are able to be more proactive in catching complications earlier.


Workflow #3: Supercharged (Very High Touch):

Patient explanation: 5-7 minutes / patient (brochures, verbal, App demonstration)
Patient enrollment: 30-60 seconds / patient
Live remote monitoring & follow-up: 15-45 mins / week / care team member (monitoring work is more distributed)

This approach builds on the “hands on” framework, by adding:

  • • More staff promotion and education of the program, such as including a hands-on App demonstration for the patient before enrollment
  • • Using more customized alerts and dashboards for specific care team members – thereby involving the more appropriate team member for different issues flagged by the platform. For example, wound care nurses are alerted for wound issues).
  • • Patient adoption, engagement and ultimately clinical outcomes are highest with this approach.

Check out our podcast episode on “How to Implement Surgical Remote Monitoring” where we discuss the topic in-depth below:

Want a step-by-step plan to help you get started with a Surgical Remote Monitoring program? Download our free whitepaper here for a practical guide on how to get started with a Surgical Remote Monitoring program today.

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