Feasibility of an Image-Based Mobile Health Protocol for Postoperative Wound Monitoring

Abstract

Background: Surgical site infection (SSI) is the most common nosocomial infection and the leading cause of readmission among surgical patients. Many SSIs develop in the postdischarge period and are inadequately recognized by patients. To address this, we developed a mobile health protocol of remote wound monitoring using smartphone technology. The current study aims to establish its feasibility among patients and providers.

Study design: We enrolled vascular surgery patients during their inpatient stay. They were trained to use our mobile health application, which allowed them to transmit digital images of their surgical wound and answer a survey about their recovery. After hospital discharge, participants completed the application daily for 2 weeks. Providers on the inpatient team reviewed submissions daily and contacted patients for concerning findings.

Results: Forty participants were enrolled. Forty-five percent of participants submitted data every day for 2 weeks, with an overall submission rate of 90.2%. Submissions were reviewed within an average of 9.7 hours of submission, with 91.9% of submissions reviewed within 24 hours. We detected 7 wound complications with 1 false negative. Participant and provider satisfaction was universally high.

Conclusions: Patients and their caregivers are willing to participate in a mobile health program aimed at remote monitoring of postoperative recovery, and they are able to complete it with a high level of fidelity and satisfaction. Preliminary results indicate the ability to detect and intervene on wound complications.

Conflict of interest statement

Disclosure Information: Nothing to disclose.

Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1.

WoundCheck application screenshots. (A, B, C) The first step is the image-taking portion of the app, with the ability to review captured images and add images as necessary. (D) The image-taking portion is followed by a series of yes or no questions about recovery, with particular focus on the wound. (E) Participants can review and change their responses before submitting their data. (F) They receive a confirmation of submission and are given the number to the clinic if they have concerns. Wound image from Shutterstock.

Figure 2.

Enrollment diagram.