Skip to main content

A Mobile Health Application to Track Patients After Gastrointestinal Surgery: Results from a Pilot Study



Many surgical readmissions are preventable. Mobile health technology can identify nascent complications and potentially prevent readmission.


We performed a pilot study of a new mobile health application in adults undergoing major abdominal surgery. Patients reported their pain, answered surveys, photographed their wound, were reminded to stay hydrated, and used a Fitbit™ device. Abnormal responses triggered alerts for further evaluation. Patients were followed postoperatively for 30 days and compliance with app use was tracked.


Thirty-one patients participated. Most were female (58%) and white (61%). Six (19%) had an ostomy as part of their surgery. 83.9% of patients completed an app-related task at least 70% of the time and 89% said using the app was easy to use. Patients generated an average of 1.1 alerts. One patient was readmitted and generated seven alerts prior to readmission. Patients participated most in collecting Fitbit data (84.8% of days) and completing a single-item photoaffective meter, but had more difficulty uploading photographs (51.4% completed). Eighty-nine percent of patients found the application easy to use.


A novel mobile health app can track patient recovery from major abdominal surgery, is easy to use, and has potential to improve outcomes. Further studies using the app are planned.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3


  1. Greenblatt DY, Weber SM, O’Connor ES, LoConte NK, Liou J-I, Smith MA. Readmission after colectomy for cancer predicts one-year mortality. Ann Surg 2010;251:659–669.

    Article  PubMed Central  Google Scholar 

  2. Stitzenberg KB, Chang Y, Smith AB, Nielsen ME. Exploring the burden of inpatient readmissions after major cancer surgery. J Clin Oncol 2015;33:455–464.

    Article  PubMed  Google Scholar 

  3. Wick EC, Shore AD, Hirose K, Ibrahim AM, Gearhart SL, Efron J, et al. Readmission rates and cost following colorectal surgery. Dis Colon Rectum 2011;54:1475–1479.

    Article  PubMed  Google Scholar 

  4. Kulaylat AN, Dillon PW, Hollenbeak CS, Stewart DB. Determinants of 30-d readmission after colectomy. J Surg Res 2015;193:528–535.

    Article  PubMed  Google Scholar 

  5. Messaris E, Sehgal R, Deiling S, Koltun WA, Stewart D, McKenna K, et al. Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum 2012;55:175–180.

    Article  PubMed  Google Scholar 

  6. Van Walraven C, Bennett C, Jennings A, Austin PC, Forster AJ. Proportion of hospital readmissions deemed avoidable: a systematic review. CMAJ 2011;183:E391–402.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Goldfield NI, McCullough EC, Hughes JS, Tang AM, Eastman B, Rawlins LK, et al. Identifying potentially preventable readmissions. Health Care Financ Rev 2008;30:75–91.

    PubMed  PubMed Central  Google Scholar 

  8. Friedman B, Basu J. The rate and cost of hospital readmissions for preventable conditions. Med Care Res Rev 2004;61:225–240.

    Article  PubMed  Google Scholar 

  9. Andersen J, Hjort-Jakobsen D, Christiansen PS, Kehlet H. Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery. Br J Surg 2007;94:890–893.

    CAS  Article  PubMed  Google Scholar 

  10. Naylor MD, McCauley KM. The effects of a discharge planning and home follow-up intervention on elders hospitalized with common medical and surgical cardiac conditions. J Cardiovasc Nurs 1999;14:44–54.

    CAS  Article  PubMed  Google Scholar 

  11. Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly. A randomized clinical trial. Ann Intern Med 1994;120:999–1006.

    CAS  Article  PubMed  Google Scholar 

  12. Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. A randomized clinical trial of nursing care for recovery from cardiac surgery. Heart Lung 1993;22:125–133.

    CAS  PubMed  Google Scholar 

  13. Mezey M, Fulmer T, McCorkle R, Strumpf NE, Nuamah IF, Adler DC, et al. A specialized home care intervention improves survival among older post-surgical cancer patients. J Am Geriatr Soc 2000;48:1707–1713.

    Article  Google Scholar 

  14. Fiordelli M, Diviani N, Schulz PJ. Mapping mHealth research: a decade of evolution. J Med Internet Res 2013;15:e95.

    Article  PubMed Central  Google Scholar 

  15. Amor JD, James CJ. Setting the scene: mobile and wearable technology for managing healthcare and wellbeing. Conf Proc IEEE Eng Med Biol Soc 2015;2015:7752–7755.

    PubMed  Google Scholar 

  16. Silva BMC, Rodrigues JJPC, de la Torre Díez I, López-Coronado M, Saleem K. Mobile-health: a review of current state in 2015. J Biomed Inform 2015;56:265–272.

    Article  PubMed  Google Scholar 

  17. Firth J, Cotter J, Torous J, Bucci S, Firth JA, Yung AR. Mobile phone ownership and endorsement of “mHealth” among people with psychosis: a meta-analysis of cross-sectional studies. Schizophr Bull 2016;42:448–455.

    Article  PubMed  Google Scholar 

  18. Pew Research Center. Demographics of mobile device ownership and adoption in the United States. Published 2017. Accessed Mar 21, 2017.

  19. Patel MS, Patel N, Small DS, Rosin R, Rohrbach JI, Stromberg N, et al. Change in length of stay and readmissions among hospitalized medical patients after inpatient medicine service adoption of mobile secure text messaging. J Gen Intern Med 2016;31:863–870.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Gandhi S, Chen S, Hong L, Sun K, Gong E, Li C, et al. Effect of mobile health interventions on the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Can J Cardiol 2017;33:219–231.

    Article  Google Scholar 

  21. Kirwan M, Vandelanotte C, Fenning A, Duncan MJ. Diabetes self-management smartphone application for adults with type 1 diabetes: randomized controlled trial. J Med Internet Res 2013;15:e235.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Armstrong K, Coyte P, Brown M, Beber B, Semple J, Armstrong K, et al. Effect of home monitoring via mobile app on the number of in-person visits following ambulatory surgery: A Randomized Clinical Trial. JAMA Surgery 2017; Published online March 22, 2017. doi:10.1001/jamasurg.2017.0111.

  23. Pollak JP, Adams P, Gay G. PAM: a photographic affect meter for frequent, in situ measurement of affect. Proceedings of the 2011 Annual Conference on Human Factors in computing systems. New York: ACM Press; 2011:725.

  24. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 1988;54:1063–1070.

    CAS  Article  PubMed  Google Scholar 

  25. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med 2009;360:1418–1428.

    CAS  Article  PubMed  Google Scholar 

  26. R Foundation for Statistical Computing. R: a language and environment for statistical computing. Vienna, R Core Team; 2016.

    Google Scholar 

  27. Fernandes-Taylor S, Gunter RL, Bennett KM, Awoyinka L, Rahman S, Greenberg CC, et al. Feasibility of implementing a patient-centered postoperative wound monitoring program using smartphone images: a pilot protocol. JMIR Res Protoc 2017;6:e26

    Article  PubMed  PubMed Central  Google Scholar 

  28. Jaensson M, Dahlberg K, Eriksson M, Grönlund Å, Nilsson U. The development of the recovery assessments by phone points (RAPP): a mobile phone app for postoperative recovery monitoring and assessment. JMIR mHealth and uHealth 2015;3:e86.

    Article  PubMed Central  Google Scholar 

  29. Semple JL, Sharpe S, Murnaghan ML, Theodoropoulos J, Metcalfe KA. Using a mobile app for monitoring post-operative quality of recovery of patients at home: a feasibility study. JMIR mHealth and uHealth 2015;3:e18.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Diaz KM, Krupka DJ, Chang MJ, Peacock J, Ma Y, Goldsmith J, et al. Fitbit®: an accurate and reliable device for wireless physical activity tracking. Int J Cardiol 2015;185:138–140.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Merkow RP, Ju MH, Chung JW, Hall BL, Cohen ME, Williams MV, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA 2015;313:483–495.

    CAS  Article  PubMed  Google Scholar 

  32. Morris MS, Graham LA, Richman JS, Hollis RH, Jones CE, Wahl T, et al. Postoperative 30-day readmission: time to focus on what happens outside the hospital. Ann Surg 2016;264:621–631.

    Article  PubMed  Google Scholar 

  33. Telem DA, Yang J, Altieri M, Patterson W, Peoples B, Chen H, et al. Rates and risk factors for unplanned emergency department utilization and hospital readmission following bariatric surgery. Ann Surg 2016;263:956–960.

    Article  PubMed  Google Scholar 

  34. Kim EK, Sheetz KH, Bonn J, DeRoo S, Lee C, Stein I, et al. A statewide colectomy experience: the role of full bowel preparation in preventing surgical site infection. Ann Surg 2014;259:310–314.

    Article  PubMed  Google Scholar 

  35. Feroci F, Lenzi E, Baraghini M, Garzi A, Vannucchi A, Cantafio S, et al. Fast-track colorectal surgery: protocol adherence influences postoperative outcomes. Int J Colorectal Dis 2013;28:103–109.

    Article  PubMed  Google Scholar 

Download references


The authors gratefully acknowledge the assistance of Victoria Jimenez and Rachel Spayd with data collection.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Heather L. Yeo.

Ethics declarations

Grant Support

This study was funded by the Society for Surgery of the Alimentary Tract and the Weill Cornell Medicine Center for Advanced Digestive Care. MMS and JSA received support from the Agency for Healthcare Research and Quality, NRSA T32-HS000066-23. HLY received su pport from the Damon Runyon Cancer Research Foundation.

Authorship Declaration

All authors listed above contributed to the conception and design of the work, drafting and critical revision of the manuscript, approved the final version for publication, and agree to accountability for all aspects of the presented work.

Conflict of Interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Symer, M.M., Abelson, J.S., Milsom, J. et al. A Mobile Health Application to Track Patients After Gastrointestinal Surgery: Results from a Pilot Study. J Gastrointest Surg 21, 1500–1505 (2017).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • mHealth
  • Telemedicine
  • Surgery
  • Readmission
  • Colorectal surgery