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Is there an outcome benefit? Patient engagement technology in addition to the electronic medical record patient portal following elective colorectal surgery

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Abstract

Background

Patient engagement technologies (PET) are an area of growing innovation and investment, but whether PET use in the setting of electronic medical record (EMR) supported patient portals are associated with improved outcomes is unknown. Therefore, we assessed PET and EMR activation among patients undergoing elective colorectal surgery on an enhanced recovery pathway.

Methods

We identified adults undergoing elective colorectal surgery between 1/2017 and 7/2021. EMR activations were assessed and patients were considered PET users if they used a proprietary PET application. Multivariable logistic regression was used to identify factors associated with PET use and determine whether the level of engagement (percentage of messages read by the patient) was associated with 30-day outcomes.

Results

484 patients (53.5% PET users, 81.6% with an activated EMR patient portal, 30.8% ≥ 70 years of age) were included. PET users were younger, more likely to have their EMR portal activated and had decreased odds of prolonged length of stay [odds ratio (OR) 0.5, 95% confidence interval (CI) 0.4–0.8]. Among patients ≥ 70 years, PET users had reduced odds of readmissions (OR 0.2, 95% CI 0.1–0.9) compared to PET non-users. The most engaged PET users had decreased morbidity (OR 0.2, 95% CI 0.1–0.8) and readmissions (OR 0.3, 95% CI 0.1–0.8) compared to the least engaged PET users.

Conclusion

When controlling for EMR activation, patients who use PET, specifically those with higher levels of engagement or aged ≥ 70, have improved outcomes following elective colorectal surgery. Interventions aimed at increasing the adoption of PET among older adults may be warranted.

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The authors received no funding for this work.

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Authors and Affiliations

  1. Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, NY, 14642, USA

    Alexa D. Melucci, Kiersten Flodman, Anthony Loria, Larissa K. Temple & Fergal J. Fleming

  2. School of Medicine and Dentistry, University of Rochester, Rochester, NY, 14642, USA

    Kiersten Flodman

  3. Division of Colorectal Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY, 14642, USA

    Holli L. Swanson, Mary K. Robinson, Larissa K. Temple & Fergal J. Fleming

  4. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, 14642, USA

    Michael J. Hasselberg

  5. Department of Medicine, University of Rochester Medical Center, Rochester, NY, 14642, USA

    Lara Evans

  6. Surgical Health Outcomes & Research Enterprise (SHORE), The University of Rochester Medical Center, Saunders Research Building, Suite 124003, 265 Crittenden Blvd, Rochester, NY, 14642, USA

    Alexa D. Melucci

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  1. Alexa D. Melucci
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Correspondence to Alexa D. Melucci.

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Disclosures

Fergal J. Fleming receives author royalties from UpToDate, Inc. Larissa K. Temple is a recipient of Patient Centered Outcomes Research Institute (PCORI) research award (HIS-1602-34355) and the Agency for Healthcare Research and Quality (AHRQ) Grant [1R18HS026189-01A1]. Alexa D. Melucci, Kiersten Flodman, Anthony Loria, Holli L. Swanson, Mary K. Robinson, Michael J. Hasselberg, and Lara Evans have no conflicts of interest or financial ties to disclose.

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Disclosure: Preliminary data from this manuscript was presented at the American College of Surgeons National Surgical Quality Improvement Program Quality and Safety Conference, July 15–17, 2022.

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Melucci, A.D., Flodman, K., Loria, A. et al. Is there an outcome benefit? Patient engagement technology in addition to the electronic medical record patient portal following elective colorectal surgery. Surg Endosc 37, 9275–9282 (2023). https://doi.org/10.1007/s00464-023-10478-z

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  • DOI: https://doi.org/10.1007/s00464-023-10478-z

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