Patient-centred perioperative mobile application in Cesarean delivery: needs assessment and development

Cesarean delivery (CD) is the most commonly performed inpatient surgery in Canada, with 103,425 performed in 2016-2017. Mobile technology can contribute to patient-centred perioperative care. Our aim was to involve patients and anesthesiologists in designing a mobile application to enhance the perioperative care of CD patients.

We completed an exploratory qualitative study involving three iterative design cycles. Individual structured phone or in-person interviews with CD patients (n = 15) and anesthesiologists (n = 9) were conducted. Thematic analysis was used to 1) assess gaps and opportunities in the anesthesiology care after CD, 2) identify roles and limitations of mobile application technology in bridging perioperative care, and 3) to solicit feedback on a prototype mobile application for the anesthesiology postoperative care of elective CD patients.

Patients and anesthesiologists were in favour of adding mobile applications to the interdisciplinary perioperative management of patients undergoing CD, particularly for providing reliable information, identifying and following patients with complications, and research in perioperative outcomes. Medical-legal issues, privacy, workflow, and payment policy frameworks are barriers for mobile technology linking patients and anesthesiologists. Our final prototype was refined to focus on timely, concise education and self-monitoring.

The participant-driven changes in direction of the prototype showed the importance of involving key stakeholders early. This study provides guidance on further iterative development and implementation of an interdisciplinary mobile platform for patient-centred perioperative care and outcomes research.