4 Ways Digital Care Journeys Support Enhanced Recovery After Surgery (ERAS)4 Ways Digital Care Journeys Support Enhanced Recovery After Surgery (ERAS)
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4 Ways Digital Care Journeys Support Enhanced Recovery After Surgery (ERAS)

August 4, 2022
By
Rachel Subramaniam

Enhanced Recovery After Surgery (ERAS) protocols are leveraged by leading healthcare organizations in order to streamline a patient’s surgical journey - from pre-op preparation through post-surgical recovery. ERAS protocols are implemented in order to reduce the patient’s surgical stress response, improve the patient experience, as well as clinical outcomes, such as reduced length of stay (LOS), readmission rates, and ED visits and facilitate recovery. The care pathways form an integrated continuum, as the patient moves from home through the pre-hospital / pre admission, preoperative, intraoperative, and postoperative phases of surgery and home again.

Healthcare providers have found that while ERAS programs on their own provide a great basis for improving post-surgical recovery, forward thinking healthcare leaders have implemented digital care journeys to supplement these programs. Digital care journey platforms like SeamlessMD support health literacy, optimize patient education and communication, help patients achieve the best recovery possible and achieve stronger ERAS clinical outcomes.

During a recent webinar, Misty Eller, Advanced Nurse Practitioner, Atrium Health, shared, “We're utilizing digital care journeys to help with ERAS. It helps us to keep patients on track and also helps with documentation, which has been a big issue within ERAS because a lot of times people are doing the activity, they're doing the mobility, they're doing all these things, but it's not documented in the EMR. The fact that we can actually translate that over, and it can be documented in the EMR is helpful.”

The following are four ways in which digital care journeys can support ERAS programs:

1. Paperless ERAS education for improved patient compliance

As patient compliance to ERAS programs is often lacking and inconsistent, the benefits of implementing ERAS programs cannot be fully realized. Historically, patients have found it difficult to keep track of patient education given to them in a physical format, such as a paper pamphlet. This is because paper-based education is easier to misplace and disregard. Furthermore, providers may find paper-based education materials out-of-date and time consuming to keep up-to-date. By providing patients with their education on a virtual platform, patients can easily access an expert-approved patient education library on their smartphone, tablet or computer. They also receive timely push notifications with daily reminders to complete tasks and to-do lists, keeping patients accountable and on track to recovery. For example, patients undergoing colorectal surgery receive preoperative education on bowel preparation, medications, diet, etc. directly on their device making it easy for them to review and follow the protocols.  

As Dr. Daniel Chu, ERAS Medical Director, UAB Medicine shares, ”Surgery is often a confusing and overwhelming process for patients... Our patients can stay connected on their desktops, laptops and mobile devices with SeamlessMD so they are engaged with the recovery process both before and after surgery.”

Furthermore, digital care journey platforms can be scaled across multiple service lines to support ERAS for colorectal surgery, cardiac surgery, liver and pancreas, gynecology, and other types of surgery. The platform provides patients with tailored feedback based on their input. For example, they might receive information from their provider on an issue they would otherwise feel the need to call about. Patients that use digital care journey platforms spend less time making unnecessary calls to their doctor.

“Phone call volumes can overwhelm staff and negatively impact operational efficiencies; by providing patients with the tools to effectively self-manage from home, patients are less likely to require multiple follow-up phone calls. The implementation of SeamlessMD has led to a reduction in phone calls, contributing to improved staff satisfaction and clinical operations,” shares Gregory D. Rushing, MD Division of Cardiac Surgery, University Hospitals.

"SeamlessMD has become essential for success for us when it comes to ERAS because it really helps with keeping patients on-task and on-target... It also helps with ERAS specifically because we can track compliance.” explains Misty B. Eller, Advanced Nurse Practitioner, at Atrium Health.

2. Remote Patient Monitoring Capabilities

Through digital care journeys, healthcare providers can remotely monitor patients via dashboards, and can rapidly intervene for patients with low protocol compliance. After discharge, the healthcare team can continue to monitor alerts and patient responses. This allows providers to monitor for early warning signs of complications (e.g. fever, incision issues) and reach out to patients to prevent ER visits and readmissions.

For example, Rhonda Bryant, MSN, RN, BCRN Patient Navigator Cardiac Surgery at University Hospitals (UH), shared how digital care journeys helped prevent an escalation of a post-surgical complication:

"I have a patient that documented his incision was draining fluid. I called him and was able to get a photo of the incision to show Dr. Abu-Omar. I then communicated with his home care team to assess the incision and teach the patient how to clean the area daily. The patient lived in southern Ohio and couldn't get a ride to Cleveland. Our quick action may have prevented the incision from getting infected."

Furthermore, digital care journey platforms make healthcare more accessible for patients that might live far from the hospital or alone. These patients have fewer options for care and might find it difficult to travel in order to receive in-person pre- and post-surgical care. The aversion towards seeking in-person care was further exacerbated by the COVID-19 pandemic. Therefore, providing options for remote care helps democratize patient access to care and pushes the bounds for the hospital to support more patients, safely while at home.

3. Delivering standardized ERAS patient education

The standardization of ERAS protocols is important because it improves the delivery and consistency of care by minimizing errors, improves clinical outcomes, optimizes healthcare resources and enhances the overall patient experience. By implementing digital care journeys, providers can digitize ERAS education and protocols, providing a centralized hub of information for patients. Furthermore, information can be updated at any time so patients always receive up-to-date ERAS education.

“This technology has clearly improved our ability to educate our patients both before and after their procedures,” said Cheryl Crisafi MSN, RN, CNL, Nurse Coordinator, Cardiac Surgery Baystate Health Heart & Vascular Program. “The enthusiasm surrounding this platform has translated into rapid implementation of our ERAS pathways.”

Furthermore, Dr. Daniel Engelman, MD, Medical Director, Heart & Vascular Center, Baystate Health, President, ERAS® Cardiac Society says: “Patient engagement technology like SeamlessMD is a recommended component in the ERAS® Cardiac guidelines. SeamlessMD has empowered our patients to be partners in their own care, leading to better patient experiences and clinical outcomes.”

4. Automated collection of ERAS-related patient-reported outcomes

Digital care journeys enable clinical teams to automate the collection and reporting of patient-reported outcomes (PROs), such as pain scores, opioid use and validated surveys (e.g. PROMIS) across an episode of care. Healthcare providers can use insights from ERAS PROs to continuously improve patient outcomes. For example, PRO collection from digital care journey platforms provides data to help providers understand actual opioid consumption in order to safely reduce opioid prescribing over time. Patients can use digital care journeys to complete opioid risk-scoring surveys and to track how their opioid consumption compares with patients undergoing a similar operation. Providers can recognize patients who may be at risk for opioid use disorders or misuse.

Dionisios Vrochides, MD, Ph.D., Vice-chair of Quality and Outcomes for Atrium Health’s Department of Surgery and the lead researcher for the END Opioid initiative shared,

"Opioid addiction is a complex problem and this technological enhancement will allow us to expand the capabilities to teach patients about safe opioid use for pain control after surgery."

Through several outcomes analyses, leading healthcare organizations have implemented digital care journeys to support their ERAS program achieving strong results such as:

Baystate Health:

  • ↓ 0.9 days LOS
  • ↓ 72% readmissions
  • ↓ 60% discharge to SNF

Rush University

  • ↓ 2.0 days LOS
  • ↓ $2,386 per patient
  • ↓ 70% SSI rate

UAB Medicine

  • ↓1.0 days LOS
  • ↓ $8100 per patient

Atrium Health

  • 93% Patient Adoption
  • 88% Patients remained engaged in-hospital
  • 62% PRO completion on QoL, pain, nausea, opioid use, compliance to ERAS pathway (i.e. ambulation and breathing exercises)

“I think digital healthcare technologies like SeamlessMD - it's a great tool to be able to package things and deliver things more consistently and in high quality,” explained Dr. Daniel Chu, ERAS Medical Director, UAB Medicine during a recent webinar How Atrium Health and UAB Medicine Use Digital Care Journeys to Improve Quality & Patient Safety.

To learn more about how digital care journeys can compliment your ERAS program, check out this whitepaper, “How Digital Patient Engagement Improves An Enhanced Recovery After Surgery (ERAS) Program”

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4 Ways Digital Care Journeys Support Enhanced Recovery After Surgery (ERAS)

Posted by:
Rachel Subramaniam
on
August 4, 2022

Enhanced Recovery After Surgery (ERAS) protocols are leveraged by leading healthcare organizations in order to streamline a patient’s surgical journey - from pre-op preparation through post-surgical recovery. ERAS protocols are implemented in order to reduce the patient’s surgical stress response, improve the patient experience, as well as clinical outcomes, such as reduced length of stay (LOS), readmission rates, and ED visits and facilitate recovery. The care pathways form an integrated continuum, as the patient moves from home through the pre-hospital / pre admission, preoperative, intraoperative, and postoperative phases of surgery and home again.

Healthcare providers have found that while ERAS programs on their own provide a great basis for improving post-surgical recovery, forward thinking healthcare leaders have implemented digital care journeys to supplement these programs. Digital care journey platforms like SeamlessMD support health literacy, optimize patient education and communication, help patients achieve the best recovery possible and achieve stronger ERAS clinical outcomes.

During a recent webinar, Misty Eller, Advanced Nurse Practitioner, Atrium Health, shared, “We're utilizing digital care journeys to help with ERAS. It helps us to keep patients on track and also helps with documentation, which has been a big issue within ERAS because a lot of times people are doing the activity, they're doing the mobility, they're doing all these things, but it's not documented in the EMR. The fact that we can actually translate that over, and it can be documented in the EMR is helpful.”

The following are four ways in which digital care journeys can support ERAS programs:

1. Paperless ERAS education for improved patient compliance

As patient compliance to ERAS programs is often lacking and inconsistent, the benefits of implementing ERAS programs cannot be fully realized. Historically, patients have found it difficult to keep track of patient education given to them in a physical format, such as a paper pamphlet. This is because paper-based education is easier to misplace and disregard. Furthermore, providers may find paper-based education materials out-of-date and time consuming to keep up-to-date. By providing patients with their education on a virtual platform, patients can easily access an expert-approved patient education library on their smartphone, tablet or computer. They also receive timely push notifications with daily reminders to complete tasks and to-do lists, keeping patients accountable and on track to recovery. For example, patients undergoing colorectal surgery receive preoperative education on bowel preparation, medications, diet, etc. directly on their device making it easy for them to review and follow the protocols.  

As Dr. Daniel Chu, ERAS Medical Director, UAB Medicine shares, ”Surgery is often a confusing and overwhelming process for patients... Our patients can stay connected on their desktops, laptops and mobile devices with SeamlessMD so they are engaged with the recovery process both before and after surgery.”

Furthermore, digital care journey platforms can be scaled across multiple service lines to support ERAS for colorectal surgery, cardiac surgery, liver and pancreas, gynecology, and other types of surgery. The platform provides patients with tailored feedback based on their input. For example, they might receive information from their provider on an issue they would otherwise feel the need to call about. Patients that use digital care journey platforms spend less time making unnecessary calls to their doctor.

“Phone call volumes can overwhelm staff and negatively impact operational efficiencies; by providing patients with the tools to effectively self-manage from home, patients are less likely to require multiple follow-up phone calls. The implementation of SeamlessMD has led to a reduction in phone calls, contributing to improved staff satisfaction and clinical operations,” shares Gregory D. Rushing, MD Division of Cardiac Surgery, University Hospitals.

"SeamlessMD has become essential for success for us when it comes to ERAS because it really helps with keeping patients on-task and on-target... It also helps with ERAS specifically because we can track compliance.” explains Misty B. Eller, Advanced Nurse Practitioner, at Atrium Health.

2. Remote Patient Monitoring Capabilities

Through digital care journeys, healthcare providers can remotely monitor patients via dashboards, and can rapidly intervene for patients with low protocol compliance. After discharge, the healthcare team can continue to monitor alerts and patient responses. This allows providers to monitor for early warning signs of complications (e.g. fever, incision issues) and reach out to patients to prevent ER visits and readmissions.

For example, Rhonda Bryant, MSN, RN, BCRN Patient Navigator Cardiac Surgery at University Hospitals (UH), shared how digital care journeys helped prevent an escalation of a post-surgical complication:

"I have a patient that documented his incision was draining fluid. I called him and was able to get a photo of the incision to show Dr. Abu-Omar. I then communicated with his home care team to assess the incision and teach the patient how to clean the area daily. The patient lived in southern Ohio and couldn't get a ride to Cleveland. Our quick action may have prevented the incision from getting infected."

Furthermore, digital care journey platforms make healthcare more accessible for patients that might live far from the hospital or alone. These patients have fewer options for care and might find it difficult to travel in order to receive in-person pre- and post-surgical care. The aversion towards seeking in-person care was further exacerbated by the COVID-19 pandemic. Therefore, providing options for remote care helps democratize patient access to care and pushes the bounds for the hospital to support more patients, safely while at home.

3. Delivering standardized ERAS patient education

The standardization of ERAS protocols is important because it improves the delivery and consistency of care by minimizing errors, improves clinical outcomes, optimizes healthcare resources and enhances the overall patient experience. By implementing digital care journeys, providers can digitize ERAS education and protocols, providing a centralized hub of information for patients. Furthermore, information can be updated at any time so patients always receive up-to-date ERAS education.

“This technology has clearly improved our ability to educate our patients both before and after their procedures,” said Cheryl Crisafi MSN, RN, CNL, Nurse Coordinator, Cardiac Surgery Baystate Health Heart & Vascular Program. “The enthusiasm surrounding this platform has translated into rapid implementation of our ERAS pathways.”

Furthermore, Dr. Daniel Engelman, MD, Medical Director, Heart & Vascular Center, Baystate Health, President, ERAS® Cardiac Society says: “Patient engagement technology like SeamlessMD is a recommended component in the ERAS® Cardiac guidelines. SeamlessMD has empowered our patients to be partners in their own care, leading to better patient experiences and clinical outcomes.”

4. Automated collection of ERAS-related patient-reported outcomes

Digital care journeys enable clinical teams to automate the collection and reporting of patient-reported outcomes (PROs), such as pain scores, opioid use and validated surveys (e.g. PROMIS) across an episode of care. Healthcare providers can use insights from ERAS PROs to continuously improve patient outcomes. For example, PRO collection from digital care journey platforms provides data to help providers understand actual opioid consumption in order to safely reduce opioid prescribing over time. Patients can use digital care journeys to complete opioid risk-scoring surveys and to track how their opioid consumption compares with patients undergoing a similar operation. Providers can recognize patients who may be at risk for opioid use disorders or misuse.

Dionisios Vrochides, MD, Ph.D., Vice-chair of Quality and Outcomes for Atrium Health’s Department of Surgery and the lead researcher for the END Opioid initiative shared,

"Opioid addiction is a complex problem and this technological enhancement will allow us to expand the capabilities to teach patients about safe opioid use for pain control after surgery."

Through several outcomes analyses, leading healthcare organizations have implemented digital care journeys to support their ERAS program achieving strong results such as:

Baystate Health:

  • ↓ 0.9 days LOS
  • ↓ 72% readmissions
  • ↓ 60% discharge to SNF

Rush University

  • ↓ 2.0 days LOS
  • ↓ $2,386 per patient
  • ↓ 70% SSI rate

UAB Medicine

  • ↓1.0 days LOS
  • ↓ $8100 per patient

Atrium Health

  • 93% Patient Adoption
  • 88% Patients remained engaged in-hospital
  • 62% PRO completion on QoL, pain, nausea, opioid use, compliance to ERAS pathway (i.e. ambulation and breathing exercises)

“I think digital healthcare technologies like SeamlessMD - it's a great tool to be able to package things and deliver things more consistently and in high quality,” explained Dr. Daniel Chu, ERAS Medical Director, UAB Medicine during a recent webinar How Atrium Health and UAB Medicine Use Digital Care Journeys to Improve Quality & Patient Safety.

To learn more about how digital care journeys can compliment your ERAS program, check out this whitepaper, “How Digital Patient Engagement Improves An Enhanced Recovery After Surgery (ERAS) Program”

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