Outcomes of Mobile Health Use in Sinonasal Surgery: Retrospective Cohort Study

Mobile health (mHealth) technologies are increasingly integrated into perioperative care to enhance patient engagement and communication. Prior studies in surgical and medical specialties suggest that mHealth platforms may be associated with reductions in hospital stay and readmissions; however, evidence supporting their impact in otolaryngology, particularly in sinonasal surgery, remains limited.

The aim of this study was to evaluate the association between perioperative enrollment in CareSense, a patient-facing mHealth platform, and postoperative health care utilization outcomes, including hospital readmissions, emergency department (ED) visits, and length of stay (LOS), among adults undergoing sinonasal surgery.

This is a retrospective cohort study performed at a single tertiary care academic medical center between May 2021 and January 2024. All adult patients (≥18 years) who underwent sinonasal surgery with two fellowship-trained rhinologists during the study period were included. CareSense was offered to all patients at the time of surgical scheduling, and enrollment was voluntary. Patients were categorized into CareSense participants and nonparticipants. Primary outcomes were all-cause hospital readmissions and ED visits within 30, 60, and 90 days following surgery. Secondary outcomes included the length of hospital stay among readmitted patients. Clinical, demographic, and outcome data were obtained through retrospective electronic health record review. Univariate analyses compared outcomes between groups, and multivariable logistic regression using generalized estimating equations was performed to estimate the association between CareSense participation and outcomes while adjusting for age, sex, hypertension, and diabetes.

A total of 1135 patients were included, of whom 340 (30%) enrolled in CareSense and 795 (70%) did not. Compared with nonparticipants, CareSense participants had lower adjusted odds ratio (OR) for readmission for any cause at 30 days (OR 0.24, 95% CI 0.08-0.75; P=.007), 60 days (OR 0.40, 95% CI 0.19-0.83; P=.01), and 90 days (OR 0.54, 95% CI 0.29-0.99; P=.04). Among patients who were readmitted, mean LOS was shorter in the CareSense group than in the nonparticipating group (0.17 vs 1.68 d; P<.001). The majority of readmissions in both cohorts were unrelated to complications of the index sinonasal procedure.

This study demonstrates the benefit of CareSense in lowering postoperative readmission rates and LOS for sinonasal surgery patients, illustrating the role of medical health technology in improving patient care and quality outcomes. Perioperative enrollment in a patient-facing mHealth platform was associated with lower postoperative health care utilization and shorter hospital length of stay following sinonasal surgery. Given the voluntary nature of enrollment and the observational design, these findings should be interpreted as observation findings and hypothesis-generating for prospective studies to more definitively assess the causal impact of mHealth interventions and to identify which components of digital perioperative care most effectively improve outcomes in otolaryngologic surgery.