Practice Improvement Project: Developing a Platform for a Remote At-Home Preoperative Evaluation for Elective...

Area of Science:

• Cardiology
• Anesthesiology
• Health Informatics

Background:

• Preanesthesia medical evaluation (PAME) is crucial for optimizing patients before surgery.
• Traditional PAME can involve logistical challenges for patients.
• Remote evaluation methods offer potential for improved accessibility and efficiency.

Purpose of the Study:

• To evaluate the feasibility, safety, and patient satisfaction of a remote cardiac evaluation protocol.
• To assess the utility of telemedicine in preanesthesia medical evaluations for noncardiac surgery.
• To compare outcomes between remote and in-person PAME.

Main Methods:

• A prospective study involving patients undergoing elective noncardiac surgery.
• Patients utilized electronic devices for remote blood pressure and ECG monitoring.
• Comparison between telemedicine-based PAME (tPAME) and in-person PAME (iPAME) groups.
• Post-procedure complications and patient satisfaction surveys were analyzed.

Main Results:

• 48 of 129 eligible patients participated (37.2% participation rate).
• No major adverse cardiovascular events occurred in either the tPAME or iPAME groups.
• One patient in the iPAME group experienced deep vein thrombosis/pulmonary embolism; another had an ER visit.
• Patients reported high satisfaction with their PAME experience.

Conclusions:

• Remote cardiac evaluation during PAME is a feasible and safe approach.
• The protocol demonstrates high patient satisfaction, supporting its integration into routine care.
• Telemedicine-based PAME can be effectively implemented for elective noncardiac surgical procedures.