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December 19, 2024
Hospitals across North America are continuing to face surgical backlogs and increased wait times owing to challenges across staffing, inpatient bed availability, and reduced operating room capacity. In Canada, 206,000 people are waiting for surgical procedures in Ontario alone as of January 2023, more than 9500 people are on the Nova Scotia wait-list, and other provinces are facing extensive backlogs. Meanwhile in the US, millions of elective surgeries and other non urgent procedures were delayed during the pandemic, which has had significant financial impact.
Today, more than 30 hospitals and health systems across North America have taken a digital health approach with SeamlessMD’s Digital Care Journey platform to combat these challenges prompted by the pandemic and deliver enhanced care for their patient populations.
Accessible on smartphones, tablets, or desktops, Digital Care Journey platforms like SeamlessMD guide patients step-by-step through their care plans. Patients are prompted through pre-op and post-op processes via condition-specific automated reminders, daily check-ins, to-do lists, and an extensive patient education library, available 24/7. Patients can self-report data such as pain scores, symptoms, range-of-motion, and share photos of their wounds through the platform remotely, enabling them to actively participate in their own care.
Engaging with patients through their everyday devices, providers can access alerts and dashboards to remotely monitor patient compliance, symptoms, recovery progress, health status, and digitally collect patient-reported outcomes and other data. It enables them to shorten length of stay, reduce readmissions, ED visits, phone calls and empower early discharge, improving the overall patient experience.
Discharging patients sooner frees up hospital beds and reduces the need to cancel procedures due to lack of beds. It also increases the number of cases that can be performed as outpatient procedures which leads to more efficient booking of operating room days reducing surgical wait lists.
Digital health innovation is at the heart of systems transformation to address ongoing challenges. And effective partnerships between healthcare organizations and digital platform providers is key for long term, sustainable success.
“Using technology to stay connected with our patients and improve their experience outside the hospital is a priority in our Digital Health strategy, and SeamlessMD is a key partner in achieving this. SeamlessMD’s remote monitoring capabilities are critical in our strategy to provide a virtual safety net for patients that leads to safe, earlier discharge and decreases the wait time for in-demand surgeries,” said Jennifer Sheils, Vice President of Strategy, Transformation and Chief Innovation Officer, Horizon Health Network.
Hospitals and health networks have benefited by deploying five key strategies with SeamlessMD.
1: Streamline pre-op processes with automated, daily patient education
The more prepared a patient is for surgery, the faster they recover and are ready for discharge. However, paper and verbal instructions can be overwhelming or easily lost or misplaced, and is also costly for providers. Instead of creating their own content, time-starved clinical leaders in a health system can adopt Digital Care Journeys to assign pre-built, evidence-based education with automated patient education sessions for their patients.
“SeamlessMD allows patients to access reliable information when they want – tailored to their specific needs. … It makes an already stressful situation more bearable for our patients,” shares Dr. Carmine Simone, Chief of Surgery Michael Garron Hospital. The hospital has seen 85% patient and family engagement rate, 100% reduction in surgery cancellations, and a 100% patient satisfaction with the platform experience.
In the preoperative phase, these digital health platforms can be used to collect anesthesia questionnaires, deliver video recordings of pre-surgery classes, and send just-in-time reminders (e.g. when to stop certain medications, how to prepare the home, when to stop eating and drinking before surgery, etc.) – all without the healthcare team having to do extra work.
With access to extensive material on their everyday devices, patients are better equipped to tackle their healthcare journey as it translates into better patient preparedness, fewer phone calls and cancellations, shorter length of stay, and fewer ED visits and readmissions. In one recent study, UAB Medicine’s gynecology team found that 84% of patients preferred digital patient education over printed materials and the implementation of Digital Care Journeys resulted in faster recovery times.
2: Increase same-day or earlier discharge by setting clear expectations
Digital health solutions help health systems streamline processes that support shortened length of stay and same-day or earlier discharge, including outlining what patients should expect and providing access to a centralized location for information about their care and recovery.
Timely pre and post-operative instructions and personalized evidence-based education allows providers to set clear expectations with patients, ensure patients are aware of discharge timelines, and improve discharge process efficiencies, key steps for safe and early discharge (e.g. early ambulation, getting out of bed safely, etc.) effectively reducing the time patients spend in the hospital. For instance, Grand River Hospital achieved a 30% decrease in length of stay and 80% decrease in readmissions for hip surgeries using SeamlessMD.
A common expectation from patients for certain surgeries, such as cardiac or hip & knee replacement has been that post-surgery, they would be transferred to a Skilled Nursing Facility / Rehab after discharge to get extra support during recovery. However, the evidence shows that most patients recover equally well at-home vis a vis SNF/Rehab. With Digital Care Journeys, patients not only have the tools and education they need to complete this recovery at home.
With the use of SeamlessMD Digital Care Journeys, Baystate Health saw 60% reduction in discharge to skilled nursing facilities for cardiac surgery patients, while University Hospitals saw a 52% reduction in discharge to SNF for their Open Heart surgery patients. “The daily health check helped me feel secure that if something was wrong I would get immediate follow up from the nurse/doctor. Also, ease of access to information about my procedure & aftercare,” shared one UH Open Heart Surgery patient.
3: Increase compliance with evidence-based care pathways
The literature shows that patient compliance with evidence-based protocols, such as Enhanced Recovery After Surgery (ERAS), is directly correlated to faster recovery and shorter length of stay. However, complicated, large paper booklets and lack of easy-to-follow education often leads to low patient adherence.
Digital patient engagement tools like SeamlessMD result in greater adherence to treatment protocols among the patient population of a health system since they have better access to their healthcare plan at all times and a better understanding of their own healthcare needs.
Studies have shown that patients enrolled in digital care journeys have completed 62% of PRO on quality of life, postoperative pain, nausea, opioid consumption, and compliance to ERAS® pathway items, including ambulation and breathing exercises.
Meanwhile, healthcare teams can automatically deliver pathway reminders, track patient compliance, and provide feedback on adherence, thereby motivating patients to stay on track. Providers can also monitor pathway compliance on dashboards and intervene sooner when a patient falls off track as well as identify poor compliance and areas for quality improvement.
“The use of digital education, remote patient monitoring and alerts to consistently engage with patients beyond the hospital setting to address any post-surgical complications were a significant factor in reducing readmissions and ED visits while increasing ERAS compliance,” shares Dr. Brent Matthews, Surgeon-in-Chief, Atrium Health.
Improving adherence has also shown to lead to cost benefits, especially with ERAS. If a patient does not follow any of the components, the cost of the episode is high in terms of variable costs but if the patient follows 100 percent of components, the outcomes, including cost, improves significantly
Features like caregiver enrollment also ensure a higher rate of compliance and reporting from the patients – 50% of patients choose to enroll a caregiver to follow along their journey.
4: Inspire confidence through Remote Patient Monitoring
When patients and providers learn that the patient will be well-supported after discharge with a Remote Patient Monitoring solution like SeamlessMD, both parties are more confident for the patient to be discharged earlier. Moreover, the accessibility to care through digital health platforms also plays an important role for serving rural populations. Through remote monitoring of health status, vital signs, symptoms, and incision photos, patients can receive faster care and avoid an ED visit or readmission.
“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,” shares Rhonda Bryant, MSN, RNBCRN Patient Navigator Cardiac Surgery Harrington Heart and Vascular Institute, University Hospitals. “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."
The Montreal Heart Institute (MHI), Canada’s largest cardiology research centre, deployed SeamlessMD Digital Care Journeys for open heart surgery, TAVI, TMVR, Other Mitral and Tricuspid Procedures to optimize patient engagement and operational efficiencies. Introducing SeamlessMD for the TAVI program provided a way to remotely monitor patients, digitally collect Patient-Reported Outcomes (PROs), and track symptoms in real-time, reducing ED visits by 50.1% and hospital readmissions by 33.5%.
A cardiac patient at MHI reported, “This program is very reassuring– particularly the education and recovery exercises.” And another shared that “The fact that we could count on the systematic monitoring team in the event of difficulties made me feel very secure.”
At the Thunder Bay Regional Health Sciences Centre (TBRHSC), an acute care hospital serving over 250,000 residents across Northwestern Ontario, deployed SeamlessMD across 12 surgical pathways including orthopedics, bariatrics, colorectal, cardiac, urology, surgical oncology, and women’s health in just 16 months to engage and remotely monitor patients. Boasting an 85% patient enrolment with a 90% activation rate, TBRHSC saw improved clinical outcomes and higher surgical throughput:
- 48% decrease in average length of stay
- 32% decrease in 30-day ED Visits
- 91% of patients felt more confident before surgery
- 97% of patients felt more confident at home after surgery
One surgical patient who has used the program at TBRHSC stated: “I like the fact that the patient is able to speak up about pains or other complaints and someone on the other end will call back and explain if my problems are normal or I should go to emergency. It makes me feel less alone while recuperating from the operation, knowing someone is listening.”
As Caroline Fanti, Director of Regional Surgical Services for TBRHSC explains, “We’ve now had several patients that had their first joint replacement surgery completed at the beginning of the pandemic, and their second joint replacement in the past months with the SeamlessMD app. The feedback we have received is very compelling with patients saying their experience was 100x better with the app and the support of our NP.”
Long-term benefits of mobile health solutions are becoming more evident as patient adoption of digital health platforms continues to increase. As with other aspects of their lives, patients today expect to have better access to their care plans, education, and health teams through easy-to-use digital channels.
Digital Care Journey platforms, acting as a virtual care companion across the patient journey, have proven to reduce surgical anxiety and increase a patient’s confidence during their recovery journey. At Grand River Hospital, 95% of hip and knee surgery patients recommend SeamlessMD, 91% said it helped them feel more confident before surgery, 89% felt more confident during recovery, and 97% felt more confident at home, knowing they have quick access to education materials and can report symptoms and progress while staying connected to their care team.
5: Optimize workflows and improve operational efficiencies
Interoperability between digital health solutions and Electronic Health Record (EHR) systems is critical for streamlining clinical workflows. Leading Canadian hospitals have utilized SeamlessMD’s direct turn-key integrations with Epic, Oracle Cerner, and MEDITECH, embedding SeamlessMD dashboards into their EHR.
- Sault Area Hospital was the first organization in Canada to integrate MEDITECH Expanse with SeamlessMD, allowing remote monitoring dashboards to be launched from the patient chart, allowing for a deeper dive into the patient’s day-to-day behavior. For Dr. Graham Elder, Chief of Orthopaedics at Sault Area Hospital, “These previously unknown details - which we can use to inform diagnosis and treatment - may prove even more valuable on-call when clinicians are assessing a patient that they are not familiar with.”
- Cornwall Community Hospital was the first in Canada to integrate SeamlessMD with its Cerner EHR using SMART on FHIR technology to streamline patient enrollment and monitoring on SeamlessMD from within the Cerner patient chart.
- St. Joseph’s Healthcare Hamilton (SJHH) was the first in Canada to deliver a fully-integrated Digital Patient Experience, connecting Dovetale (Epic) MyDovetale (Epic MyChart) with SeamlessMD. “This allows patients to easily access SeamlessMD from their patient portal account, and for providers to remotely monitor patients from right within the EMR,” shares Andriana Lukich, Director of Digital Solutions at SJHH.
“What we found to be probably the most valuable and the most standout in this relationship [with SeamlessMD] is the Epic integration between SeamlessMD and MultiCare’s instance of Epic, both on the provider side and on the patient side within MyChart. Using the SMART on FHIR integration via the App Orchard, providers really can monitor patients without leaving Epic” shared Ben Chao, President CareConnect at MultiCare, an 11-hospital health system in the state of Washington.
SeamlessMD continues to collaborate with hospitals across North America to enable providers to better engage, connect, and monitor patients beyond the four walls of the hospital. If you’re looking to learn how Digital Care Journeys can increase surgical throughput, reduce surgical wait times, and improve patient flow by boosting same-day surgery, shortening length of stay, and reducing last-minute cancellations, readmissions, and ED visits, watch this tech talk with Dr. Joshua Liu or request a personalized demo.
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