Impact of Patient-Reported Outcome Monitoring via Recovery Tracker on Post-Discharge Outcomes After Colorectal...

Area of Science:

• Health Informatics
• Surgical Outcomes Research
• Patient-Reported Outcomes

Background:

• Electronic platforms for remote symptom monitoring can identify surgical patients at risk for acute care visits.
• Memorial Sloan Kettering Cancer Center (MSKCC) utilizes the Recovery Tracker (RT) patient-reported outcome (PRO) system for post-ambulatory procedure symptom monitoring since 2016.
• In 2021, RT was expanded to monitor patients undergoing inpatient colorectal surgery.

Purpose of the Study:

• To assess the impact of Recovery Tracker (RT) implementation on urgent care utilization and 30-day readmission rates in elective inpatient colorectal surgery patients.
• To determine if patient engagement with the RT system influences these post-operative outcomes.

Main Methods:

• Retrospective observational study comparing patients undergoing elective colorectal surgery during the RT implementation period (March 2021-December 2022) with a historical control group (February 2019-February 2020).
• Primary outcome: potentially unnecessary urgent care center (UCC) visits without inpatient admission.
• Secondary outcomes: 30-day readmission rates and survey engagement; multivariable logistic regression for adjusted comparisons.

Main Results:

• The RT cohort (1941 patients) showed higher rates of UCC visits without admission (4.43% vs. 1.6%) and 30-day readmissions (9.74% vs. 6.88%) compared to the control group (1206 patients).
• RT implementation was independently associated with increased odds of UCC visits (OR 2.80) and readmissions (OR 1.43).
• RT users who completed at least one survey (70.2%) had significantly lower odds of readmission (OR 0.56) compared to non-responders.

Conclusions:

• Engagement with the RT system correlated with a 44% reduction in readmission risk, identifying non-responders as a vulnerable subgroup requiring targeted support.
• While overall post-discharge care utilization increased post-RT implementation, active PRO reporting acted as a protective factor against readmission.
• Strategies to enhance engagement with remote monitoring tools are crucial, particularly for patients facing potential barriers like technological challenges or increased vulnerability.