How to Implement Digital Patient Engagement for Cardiothoracic Enhanced Recovery After Surgery (ERAS)

WHITEPAPER PREVIEW

Chapter one: Why Digital Patient Engagement for Cardiothoracic Enhanced Recovery After Surgery (ERAS)?

The healthcare journey can be a confusing and overwhelming process for cardiothoracic patients. Patients are learning complex instructions, managing anxiety, and dealing with stress – often for the first time. Research suggests that over 30% of patients undergoing cardiothoracic procedures or chronic care journeys surgery can experience anxiety. 1

Providers often feel as if they are sending patients into a blackhole, especially after discharge. Although providers hope for patients to have a straightforward recovery, the reality is that:

• 30-day mortality rate for over 774,000 coronary artery bypass surgeries was 2.3%, and was 3.4% for over 109,000 isolated valve surgeries. 2
• 30-day cardiac surgical readmissions have been observed as high as 12.3%. 3

Digital Patient Engagement represents a scalable way for providers to stay connected with cardiothoracic ERAS patients pre- and post-discharge, thereby increasing confidence for earlier discharge and improving patient safety.

In fact, the Enhanced Recovery After Surgery (ERAS®) Cardiac Society, recently published an article in JAMA that recommends using Digital Patient Engagement as one of 22 interventions to deliver standardized ERAS protocols and to collect ERAS-related patient-reported outcomes (e.g. pain, opioid consumption and patient compliance). 4

Many hospitals and health systems have successfully implemented Digital Patient Engagement for Cardiothoracic ERAS, including:

• Baystate Health: ↓ 0.9 days Length of Stay (LOS), ↓72% 30-day readmissions, ↓60% SNF use 5
• St. Francis Hospital: ↓45% 30-day readmissions during COVID-19 6
• Prairie Heart Institute: ↓ 1.0 days LOS, ↓45% 30-day readmissions, ↓64% SNF use 7

In this white paper, we will walk you through the nuts & bolts of implementing a Digital Patient Engagement program for Cardiothoracic ERAS to achieve similar results to the organizations above.

1 Carneiro, A.F., Mathias, L.A., Junior, A.R., et al. (2009). Evaluation of preoperative anxiety and depression in patients undergoing invasive cardiac procedures. Revbras anestiol, 59(4):431-8. https://doi.org/10.1016/j.athoracsur.2013.10.040

2 Mazzeffi M, Zivot J, Buchman T, Halkos M. In-hospital mortality after cardiac surgery: patient characteristics, timing, and association with postoperative length of intensive care unit and hospital stay. Ann Thorac Surg, 97(4):1220-5. https://doi.org/10.1016/j.athoracsur.2013.10.040

3 Trooboff, S., Magnus, P., Ross, C., Chaisson, K., Kramer, R., & Helm, R. et al. (2019). A multi‐center analysis of readmission after cardiac surgery: Experience of The Northern New England Cardiovascular Disease Study Group. Journal Of Cardiac Surgery, 34(8), 655-662. https://doi.org/10.1111/jocs.14086

4 Engelman DT, Ben Ali W, Williams JB, et al. Guidelines for Perioperative Care in Cardiac Surgery: Enhanced Recovery After Surgery Society Recommendations. JAMA Surg, 2019;154(8):755–766. doi:10.1001/jamasurg.2019.1153

5 Sardana, A. (2020). Implementing a Patient Engagement Platform For Cardiac Enhanced Recovery After Surgery. [Case study]. https://seamless.md/wp-content/uploads/2020/01/Seamless-MD-Baystate-case-study.pdf

6 Gomez, R., & Sardana, A. (2020, September 28). St. Francis Hospital Keeps Cardiac Patients Safe During COVID-19 with SeamlessMD, Cuts Readmission Rate by 45% [Press release]. https://www.einpresswire.com/article/527206715/st-francis-hospital-keeps-cardiac-patients-safe-during-covid-19-with-seamlessmd-cutsreadmission-rate-by-45

7 Sardana, A. (2020). Leveraging Patient Engagement Technology to Deliver a Virtual Cardiac Surgical Home. [Case study]. https://seamless.md/wp-content/uploads/2020/01/Prairie-case-study-updated.pdf

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