Appendectomy, Laparoscopic, Cholecystectomy, Laparoscopic, Cholecystectomy, Robotic
Conditions
Keywords
Virtual Visits, Telehealth
Brief summary
The purpose of this study is to implement and evaluate postoperative virtual care visits for patients who undergo a laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy. The investigators aim to better understand whether postoperative virtual care visits will not result in a greater composite measure of the occurrence of hospital encounters within Atrium Health (AH) for the 30 days following surgery than standard in-person clinic care. The investigators also aim to better understand whether postoperative virtual care visits provide time and cost savings, and provide equal or improved patient satisfaction and convenience.
Detailed description
Participants will be randomized to complete either a postoperative follow-up visit using virtual care technology or by attending a standard in-person visit at the clinic. The virtual visit uses a camera-enabled device and internet access to provide live access to the medical professional. Surveys to assess patient satisfaction and convenience will be administered by email on the day of the postoperative follow-up visit. Additional information including demographics, hospital encounters within 30 days of surgery, length of time of the follow-up visit, travel cost and time, whether additional follow-up care is required, and complications after surgery will be collected to evaluate postoperative virtual care visits. Subject participation in the study will end after follow-up care is complete or at 30 days, whichever occurs last.
Interventions
OTHERVirtual Visit
Participants will be given information about how to enroll in virtual care. Participants will use their own camera-enabled device with internet connection to see and speak to the medical professional in real-time and complete the virtual follow-up visit.
Sponsors
American College of Surgeons
Wake Forest University Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Willing to comply with all study procedures and be available for the duration of the study * English speaking * Able to read * Have an email address * Scheduled to undergo a laparoscopic appendectomy, laparoscopic cholecystectomy or robotic cholecystectomy OR have undergone an unplanned (urgent or emergent) laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy * Have surgery performed by a surgeon at either Carolinas Medical Center-Main or Carolinas Medical Center- Mercy who provides emergency general surgery clinical coverage * Live in North Carolina or South Carolina
Exclusion criteria
* Unable to complete a virtual visit (due to lack of appropriate technology, necessary technology skills, other); * Medical condition, laboratory finding, or physical exam finding that precludes participation (patients at high risk for complications, particularly those with perforated appendicitis, patients with active cocaine abuse) * Postoperative length of stay greater than or equal to 4 days * Discharged with drains that need to be removed at a postoperative visit * Admitted from or discharged to assisted living facility, skilled nursing facility, or location other than home * Have chronic pain for which the participant takes narcotic medication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Composite measure of the occurrence of hospital encounters | from date of surgery until the date of 30 days after surgery | composite measure of the occurrence of hospital encounters for the 30 days following surgery including all-cause and any-site inpatient, observational, and emergency department visits within Carolinas HealthCare System |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Patient satisfaction score | date of follow-up visit, approximately 14 days after date of surgery | self-reported patient satisfaction rating for follow-up visit assessed by survey |
| Patient convenience score | date of follow-up visit, approximately 14 days after date of surgery | self-reported patient convenience rating for follow-up visit assessed by survey |
| Rate of postoperative follow-up | date of follow-up visit, approximately 14 days after date of surgery | percent of patients who receive a postoperative follow-up visit |
| Postoperative follow-up visit time length in minutes | date of follow-up visit, approximately 14 days after date of surgery | total time of postoperative follow-up visit in minutes |
| Patient travel time to clinic in minutes | date of follow-up visit, approximately 14 days after date of surgery | total patient travel time from home to postoperative follow-up clinic in minutes |
| Patient cost savings in dollars | date of follow-up visit, approximately 14 days after date of surgery | Patient gas cost savings for travel from home to postoperative follow-up clinic |
| Rate of postoperative no-shows | date of follow-up visit, approximately 14 days after date of surgery | percent of scheduled postoperative follow-up appointments in which patients do not complete |
Countries
United States
Outcome results
None listed