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Impact of Consumer Wearables Data on Pediatric Surgery Clinicians' Management: Multi-Institutional Scenario-Based
Michela Carter1, Samuel C Linton1, Suhail Zeineddin1
1Division of Pediatric Surgery, Department of Surgery, Ann and Robert H Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Insights
Objective wearable data from consumer devices can improve remote monitoring of pediatric surgical patients, reducing unnecessary emergency department visits and increasing clinician confidence in postoperative care. This technology offers real-time recovery metrics for better patient management.
Area of Science:
- Pediatric Surgery
- Digital Health
- Remote Patient Monitoring
Background:
- Parents currently lack objective tools to assess their child's recovery post-surgery, relying on subjective reports.
- This subjectivity can lead to increased emergency department (ED) visits and treatment delays.
- Consumer wearable devices offer potential for objective, remote data collection for improved postoperative assessment.
Purpose of the Study:
- To evaluate the impact of remote wearable device data on clinicians' management of simulated pediatric postoperative patients.
- To assess changes in likelihood of ED referral and clinician confidence when objective data is added to simulated telephone encounters.
Main Methods:
- 3 simulated appendectomy recovery scenarios were presented to 34 clinicians across 5 children's hospitals.
- Scenarios were supplemented with wearable data (reassuring or concerning for complications).
- Clinicians rated likelihood of ED referral before and after data addition and reported confidence.
Main Results:
- Reassuring wearable data decreased the likelihood of ED referral (P<.01).
- Concerning wearable data increased ED referral likelihood in 1 of 3 scenarios (P<.001).
- Clinician confidence in recommendations increased significantly (76%-88%) with wearable data integration.
Conclusions:
- Wearable device data integration improved remote patient management for pediatric surgical patients.
- Objective recovery metrics from wearables can reduce healthcare use and care delays.
- Wearable technology shows promise as a postoperative monitoring tool.
Background:
At present, parents lack objective methods to evaluate their child's postoperative recovery following discharge from the hospital. As a result, clinicians are dependent upon a parent's subjective assessment of the child's health status and the child's ability to communicate their symptoms. This subjective nature of home monitoring contributes to unnecessary emergency department (ED) use as well as delays in treatment. However, the integration of data remotely collected using a consumer wearable device has the potential to provide clinicians with objective metrics for postoperative patients to facilitate informed longitudinal, remote assessment.
Objective:
This multi-institutional study aimed to evaluate the impact of adding actual and simulated objective recovery data that were collected remotely using a consumer wearable device to simulated postoperative telephone encounters on clinicians' management.
Methods:
In total, 3 simulated telephone scenarios of patients after an appendectomy were presented to clinicians at 5 children's hospitals. Each scenario was then supplemented with wearable data concerning or reassuring against a postoperative complication. Clinicians rated their likelihood of ED referral before and after the addition of wearable data to evaluate if it changed their recommendation. Clinicians reported confidence in their decision-making.
Results:
In total, 34 clinicians participated. Compared with the scenario alone, the addition of reassuring wearable data resulted in a decreased likelihood of ED referral for all 3 scenarios (P<.01). When presented with concerning wearable data, there was an increased likelihood of ED referral for 1 of 3 scenarios (P=.72, P=.17, and P<.001). At the institutional level, there was no difference between the 5 institutions in how the wearable data changed the likelihood of ED referral for all 3 scenarios. With the addition of wearable data, 76% (19/25) to 88% (21/24 and 22/25) of clinicians reported increased confidence in their recommendations.
Conclusions:
The addition of wearable data to simulated telephone scenarios for postdischarge patients who underwent pediatric surgery impacted clinicians' remote patient management at 5 pediatric institutions and increased clinician confidence. Wearable devices are capable of providing real-time measures of recovery, which can be used as a postoperative monitoring tool to reduce delays in care and avoidable health care use.
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