Abstract
BackgroundThere is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before and after surgery in an efficiency-focused health care environment.ObjectiveThe objective of this study is to design, develop, and evaluate the acceptability and feasibility of a novel planning-, outcomes-, and analytics-based smartphone app called ManageMySurgery (MMS) in patients undergoing elective spine surgery (MMS-Spine).MethodsThe development process of the MMS app was conducted over 2 sequential stages: (1) an evidence-based intervention design with refinement from surgeon and patient feedback and (2) feasibility testing in a clinical pilot study. We developed a novel, mobile-based, Health Insurance Portability and Accountability Act–compliant platform for interventional and surgical procedures. It is a patient-centric mobile health app that streamlines patients’ interactions with their care team. MMS divides the patient journey into phases, making it feasible to provide customized care pathways that meet patients’ unique needs. Patient-reported outcomes are easily collected and conform to the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) standard.ResultsWe tested the feasibility of the MMS-Spine app with patients undergoing elective spine surgery at a large academic health system. A total of 47 patients undergoing elective spine surgery (26 cervical spine and 21 lumbar spine surgeries) downloaded and used MMS-Spine to navigate their surgical journey, quantify their baseline characteristics and postoperative outcomes, and provide feedback on the utility of the app in preparing for and recovering from their spinal surgery. The median age was 59.0 (range 33-77) years, 22 of the 47 patients (47%) were women, and 26 patients (55%) had commercial insurance. Of the 47 patients, a total of 33 (70%) logged in on an iOS device, 11 (23%) on an Android device, and 3 (6%) on a computer or tablet. A total of 17 of the 47 patients (36%) added a caregiver, of which 7 (41%) logged in. The median number of sign-ins was 2. A total of 38 of 47 patients (81%) completed their baseline preoperative PROMIS-29 outcomes, and 14 patients (30%) completed at least one PROMIS-29 survey during the postoperative period. Of the 24 patients who completed the MMS survey, 21 (88%) said it was helpful during preparation for their procedure, 16 (67%) said it was helpful during the postoperative period, and 23 (96%) said that they would recommend MMS to a friend or family member.ConclusionsWe used a patient-centered approach based on proven behavior change techniques to develop a comprehensive smartphone app for patients undergoing elective spine surgery. The optimized version of the app is ready for formal testing in a larger randomized clinical study to establish its cost-effectiveness and effect on patients’ self-management skills and long-term outcomes.
Highlights
Disorders of the spine are among the most prevalent medical conditions worldwide
We used a patient-centered approach based on proven behavior change techniques to develop a comprehensive smartphone app for patients undergoing elective spine surgery
Patients can self-report their outcomes and access frequently asked question MMS (FAQ), receive notifications, and connect to a variety of multimedia resources to educate them about their procedure and ways in which they can prepare for and recover from their surgery in order to optimize outcomes (Figure 4)
Summary
Disorders of the spine are among the most prevalent medical conditions worldwide. In the United States, over US $85 billion is spent annually on spine-related problems, which are the second leading cause of hospital-related visits after the common cold [1]. When conservative options have been exhausted, many patients undergo spine surgery to relieve their pain. Increasing efficiency and cost pressures have significantly impacted postoperative care. Patients are being discharged earlier, and symptoms that would have previously prompted a longer postoperative stay are being managed remotely. Without easy access to reliable remote medical information and risk assessment, patients may delay seeking care, experience unnecessary anxiety, or seek unnecessary care. Given the ubiquity of smartphone use, mobile apps are actively being implemented as platforms to connect care providers with patients and provide information and communication outside of a traditional medical office visit. There is a great unmet clinical need to provide patients undergoing spinal surgery and their caregivers with ongoing, high-quality care before and after surgery in an efficiency-focused health care environment
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
