Evaluation of electronic screening in the preoperative process.

Area of Science:

• Anesthesiology
• Health Informatics
• Surgical Patient Management

Background:

• Increasing patient volumes and complexity strain traditional preoperative processes.
• Efficient patient stratification is crucial for sustainable surgical care.
• The need for optimized preoperative assessment is paramount.

Purpose of the Study:

• To evaluate an electronic screening application's ability to differentiate patients requiring preoperative consultation from low-risk individuals.
• To assess the diagnostic accuracy and agreement of electronic screening against standard preoperative assessment.
• To determine patient satisfaction with electronic preoperative screening.

Main Methods:

• A prospective cohort study involving 1395 adult patients undergoing surgery or procedural sedation.
• Assessment of a novel electronic preoperative screening application with up to 185 health-related questions.
• Comparison of the electronic system's recommendations with anesthesiologist assessments, including ASA-PS classification.

Main Results:

• The electronic system demonstrated high sensitivity (97.5%) in identifying patients needing further consultation.
• Agreement between electronic screening and anesthesiologist assessment was poor (ĸ = 0.04), with significant discrepancies.
• Agreement on American Society of Anesthesiologists physical status (ASA-PS) classification was weak (ĸ = 0.48).
• A majority of patients (78.0%) reported positive experiences with electronic screening.

Conclusions:

• Electronic screening reliably identifies patients suitable for same-day anesthesia assessment, potentially reducing preoperative clinic visits.
• The application shows promise for safely streamlining patient pathways.
• Further refinement may be needed to improve agreement with expert clinical judgment.