Development and Evaluation of a Smartphone Application for Patients after Vascular Surgery

Unplanned hospital readmission following vascular surgery remains common and is often related to wound complications, poor communication, and inadequate postdischarge support. We developed a patient-centered smartphone application, the Vascular Surgery Discharge Application (VASDA), and conducted a qualitative and quantitative feasibility study to evaluate patient experiences and perceptions after a variety of open lower extremity bypass procedures (LEB).

A single-center, mixed-methods feasibility study enrolled patients undergoing LEB at discharge, and patients were instructed to use VASDA during the 30-day postdischarge period. The application incorporated validated surveys assessing mobility (Activity Measurement for Post-Acute Care), pain (Pain, Enjoyment, General Activity scale), and mood (Patient Health Questionnaire-2), as well as a wound assessment tool, a real-time messaging platform, and wound photography. Usability was quantified using the System Usability Scale (SUS) and Mobile App Rating Scale (MARS). Semi-structured interviews were conducted to assess patient experience. Interviews were transcribed and analyzed for thematic content.

Forty-five patients were enrolled following the study protocol. Overall, 82.2% of participants used the application daily for at least 25 of 30 days. Via the smartphone application, patients submitted surveys, wound photographs, and alerts prompted earlier clinical evaluation in 22.7% of participants. The 30-day unplanned readmission rate was 11.1% for the study cohort. AM-PAC returned to baseline by postoperative day 30, while PEG and PHQ-2 improved beyond preoperative baseline. Usability was high (SUS >80; MARS domains ≥4.0). Qualitative analysis identified themes of increased confidence, enhanced communication, early problem identification, increased emotional support, and created a perceived safety net for patients.

The VASDA smartphone application demonstrated high feasibility, acceptability, and adherence rates among patients recovering from open vascular surgery. The application was demonstrated to be effective in identification of postdischarge complications, may assist to lower readmission rates, and aided in early identification of postoperative complications. The VASDA smartphone application demonstrated improved patient communication, confidence, and perceived recovery after discharge.