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December 19, 2024
Recently Dr. Sabrena Noria, Surgical Director of Bariatric Surgery at Ohio State University’s (OSU) Wexner Medical Center, shared insights on how her center uses digital care journeys (SeamlessMD) to engage and track patients from referral through surgery - which has helped OSU reduce time to surgery by 1.5 months already.
To start: why look for a digital solution in the first place?
“With bariatric surgery, there's so many steps that a patient has to take. There are months and months of time between a patient submitting an application to actually getting surgery… because they need their psych eval, dietary eval, medical eval, all that kind of stuff.. because of this, obviously, patients do get confused… in order to streamline the process and mitigate delays… we created this virtual patient navigation platform… it's like your personal cruise director to get you to surgery,” explained Dr. Noria
Digital care journeys involve leveraging a patient’s own smartphone, tablet or computer to send patients reminders, deliver education and remotely monitor patient progress. Specifically for the process of getting patients to bariatric surgery, this means:
- Keeping patients motivated and on track to achieve insurance clearance milestones
- Digitally guide patients with interactive patient education, automatically nudge patients and automate to-do lists (e.g. completing tests, appointments etc.)
- Automatically collecting data on patient progress with pre-surgery milestones
- Getting patient confirmation of completed milestones and obtaining documentation of proof in dashboards
- Reducing workforce burden by streamlining coordinator workflows to better manage patients through the journey
- Eliminating spreadsheets and switching to smart dashboards to monitor patient progress, including identifying bottlenecks in the process for each patient
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You can watch the whole webinar here. Below are 4 lessons that Dr. Noria shared from OSU’s experience using this type of solution:
1. Digital care journeys can reduce time to bariatric surgery by at least 1.5 months - and perhaps up to 3 months.
An analysis by Dr. Noria’s team presented at the 2022 Annual Meeting for the American Society for Metabolic and Bariatric Surgery (ASMBS) found that use of the digital platform “shortened time (to surgery) by about 1 and a half months - which when you're talking about a 6 month span is no small feat.”
Since then, a more recent analysis at OSU “showed it (time to surgery) shortened by about, you know, close to 3 months. I think that we've doubled the time now… we know that when you engage with this, you get to surgery faster… because I think it's like your own personal checklist.”
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2. The business case to hospital leadership for a digital care journey platform should focus on getting patients to surgery faster.
It is a fairly straightforward business case to hospital leadership because each additional bariatric surgery case provides $6,000 to $8,000 in additional profit for a typical health system.
As Dr. Noria shared: “the argument that you make to the financial leadership in your institution is that this application can get patients to the OR faster… so the more patients you can get in, the more you can get done… It's really that simple.”
She went on to explain that the process for getting a patient to bariatric surgery is complex and requires a lot of resources, unlike a more simple procedure (e.g. gallbladder surgery). OSU has found that digital care journeys can significantly reduce time and resources needed for the pre-surgery process.
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3. A key reason why Digital Patient Engagement works to improve patient adherence to pre-surgery milestones is by helping patients understand the “Why”
Although the to-do lists keep patients aware of what to do, part of the secret sauce in how digital care journeys are designed is providing just-in-time explainers for why patients should complete a milestone requirement.
As Dr. Noria explains:
“When the app asks them, have you completed this appointment, I think that allows them to get into the materials that have been developed and keeps them motivated… Why do I have to have protein? What's the point of hydration? … All those little things that we take for granted because this is what we (providers) do day in and day out is new for patients. And to have that at their fingertips, I think, keeps them engaged. So I think the app itself, the list itself, it just keeps them on track - but I think the teaching materials keeps them engaged.”
4. A digital platform to guide patients from referral to surgery has very high patient-rated usability
Referencing research her team published in Obesity Surgery, Dr. Noria explained how her team studied the usability of the platform with their patients, finding that usability scores were “in the 97th percentile, which obviously is very highly usable.” on the validated System Usability Scale (SUS).
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