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From Repair to Reply: Characterizing Utilization Patterns and Timing of Patient Electronic Communication in Cleft
Thalia Le1,2, Anthony Southern1,2, Noon Awad1,2
1Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Colorado Anschutz Medical Campus.
The Journal of Craniofacial Surgery
|July 24, 2026
Summary
Patient electronic communication (PEC) is common in pediatric cleft lip and/or palate (CLP) surgery, with most messages sent before surgery. This highlights a need for better preoperative education and support for families.
Area of Science:
- Pediatric surgery
- Craniofacial anomalies
- Health informatics
- Patient engagement
Background:
- Patient electronic communication (PEC) enhances patient engagement and care continuity.
- PEC use in pediatric cleft lip and/or palate (CLP) surgery is understudied.
- Understanding perioperative PEC patterns is crucial for optimizing care.
Purpose of the Study:
- To characterize perioperative PEC use in pediatric CLP surgery patients.
- To identify factors associated with communication burden in this population.
- To explore the content and timing of patient-initiated electronic messages.
Main Methods:
- Retrospective analysis of PECs from pediatric CLP surgery patients (Jan 2023-Dec 2024).
- Messages categorized by volume and content from scheduling to 90 days postoperatively.
- Multivariable regression models assessed predictors of PEC use and volume, including demographics, clinical factors, and Social Vulnerability Index (SVI).
Main Results:
- 77.6% of patients sent PECs, with a mean of 2.6 messages per patient; 60.4% occurred preoperatively.
- Logistical coordination, feeding/nutrition, and orthodontic issues were dominant message categories.
- Increased PEC volume correlated with longer hospital stay and prior surgeries; higher ASA classification and readmission were linked to decreased volume.
Conclusions:
- PEC is highly prevalent in pediatric CLP surgery families, primarily used for preoperative logistical and anticipatory needs.
- Message content reveals unmet needs in logistics, feeding, devices, and wound care.
- Findings suggest opportunities for targeted perioperative education to address patient and family concerns.
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