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According to a national study by researchers in Hamilton, patients using take-out technology after non-elective surgery resulted in significantly greater detection and correction of medication errors and reduction in patient pain.
The study examined patient outcomes for virtual care and automated remote monitoring (RAM) – video calls with nurses and doctors, and self-monitoring of vital signs using portable devices.
Research has also raised the possibility of a reduction in acute hospital care through virtual care and AMR.
We started the study in the early months of the pandemic, when hospitals were challenged to drastically cut back on elective care. “
PJ Devereaux, co-principal investigator of the study, McMaster University
He is a Principal Investigator at the Population Health Research Institute (PHRI), Professor and Director of the Division of Perioperative Care at McMaster University, and Cardiologist and Perioperative Care Physician at Hamilton Health Sciences.
Half of 905 postoperative patients at nine sites in Hamilton, Kingston, London, Ottawa and Edmonton in Canada were randomized to use home technology – a cellular tablet and RAM equipment to measure their heart rate, blood pressure, saturation. oxygen, their breathing heart rate, body temperature and weight – for 30 days after discharge from hospital.
These patients also took photos of all surgical wounds, and all data was sent back via cellular connection to the healthcare team. Patients in this group also had virtual access to a nurse or doctor 24/7.
The other half of patients received standard care, that is, seeing a health care provider usually in person within 30 days of discharge from hospital, with patients being encouraged to contact their surgeon for advice. any concerns about medications or symptoms during this time.
The study found that fewer patients with take-out technology had to return to hospital for care – 22% compared to 27% of those with standard care.
It also found that more patients in the virtual care group compared to the standard care group had a medication error detected (30% vs. 6%, respectively) and corrected (28% vs. 4%, respectively) .
In addition, fewer virtual care patients – a difference of 10 to 14 percent less – reported pain at different times during the month compared to the standard care group.
“The pandemic is just the tip of the iceberg, in terms of the potential of virtual care and how healthcare can be transformed,” said study co-principal investigator Michael McGillion, PHRI scientist and associate professor at McMaster’s School of Nursing.
“Frontline nurses have the opportunity to lead the charge in terms of virtual care from hospital to home, working with doctors and allied health workers,” he added.
Analyzes suggested that virtual care and AMR reduced the frequency of hospital readmissions, emergency department visits, or emergency care center visits when the patient was receiving high escalation of virtual care, such as frequent attendance. from a doctor by the nurse to the care of the patient, but not in cases with lower levels of escalation.
The results of the study were published online today in the British Medical Journal (BMJ).
The authors note in the article that more trials are needed to improve efficacy, such as not all patients need to interact with a nurse on days 1 to 15 and every other day from days 16 to 30 after discharge from hospital, and the cost-effectiveness of virtual care with RAM.
Source:
Journal reference:
McGillion, MH, et al. (2021) Post-discharge virtual care after surgery with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomized controlled trial. British medical journal. doi.org/10.1136/bmj.n2209.
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