Postoperative Care Using a Secure Online Patient Portal: Changing the (Inter)Face of General Surgery.

Abstract:

BACKGROUND:Many patients seek greater accessibility to health care. Meanwhile, surgeons face increasing time constraints due to workforce shortages and elevated performance demands. Online postoperative care may improve patient access while increasing surgeon efficiency. We aimed to evaluate patient and surgeon acceptance of online postoperative care after elective general surgical operations. STUDY DESIGN:A prospective pilot study within an academic general surgery service compared online and in-person postoperative visits from May to December 2014. Included patients underwent elective laparoscopic cholecystectomy, laparoscopic ventral hernia repair, umbilical hernia repair, or inguinal hernia repair by 1 of 5 surgeons. Patients submitted symptom surveys and wound pictures, then corresponded with their surgeons using an online patient portal. The primary outcome was patient-reported acceptance of online visits in lieu of in-person visits. Secondary outcomes included detection of complications via online visits, surgeon-reported effectiveness, and visit times. RESULTS:Fifty patients completed both online and in-person visits. Online visits were acceptable to most patients as their only follow-up (76%). For 68% of patients, surgeons reported that both visit types were equally effective, while clinic visits were more effective in 24% and online visits in 8%. No complications were missed via online visits, which took significantly less time for patients (15 vs 103 minutes, p < 0.01) and surgeons (5 vs 10 minutes, p < 0.01). CONCLUSIONS:In this population, online postoperative visits were accepted by patients and surgeons, took less time, and effectively identified patients who required further care. Further evaluation is needed to establish the safety and potential benefit of online postoperative visits in specific populations.

journal_name

J Am Coll Surg

authors

Kummerow Broman K,Oyefule OO,Phillips SE,Baucom RB,Holzman MD,Sharp KW,Pierce RA,Nealon WH,Poulose BK

doi

10.1016/j.jamcollsurg.2015.08.429

subject

Has Abstract

pub_date

2015-12-01 00:00:00

pages

1057-66

issue

6

eissn

1072-7515

issn

1879-1190

pii

S1072-7515(15)01500-8

journal_volume

221

pub_type

杂志文章
  • Determining benchmarks for evaluation and management coding in an academic division of general surgery.

    abstract:BACKGROUND:Academic divisions of general surgery are facing ever-increasing financial pressures. Cost-cutting is a common approach to maintaining profitability, but strategies to increase revenue should not be ignored. One specific avenue for enhanced revenue generation in general surgery is that of coding for evaluati...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2004.03.002

    authors: Kuo PC,Douglas AR,Oleski D,Jacobs DO,Schroeder RA

    更新日期:2004-07-01 00:00:00

  • Evaluation of operative stress and peritoneal macrophage function in minimally invasive operations.

    abstract:BACKGROUND:Laparoscopic operative procedures have decreased postoperative pain and the length of hospitalization. In addition, evidence supports a physiologic benefit from laparoscopic surgery. By analyzing several parameters of peritoneal macrophage function, we report a comparison of the magnitude of postoperative st...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:

    authors: Iwanaka T,Arkovitz MS,Arya G,Ziegler MM

    更新日期:1997-04-01 00:00:00

  • Surgical management of acute right lower-quadrant pain in pregnancy: a prospective cohort study.

    abstract:BACKGROUND:The etiology of right lower-quadrant pain in pregnant patients is a challenge in diagnosis. We discuss the surgical issues among pregnant patients with right lower-quadrant pain and demonstrate the method to diagnosis. STUDY DESIGN:This was a prospective cohort study with enrollment during 2 years. Pregnant...

    journal_title:Journal of the American College of Surgeons

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.jamcollsurg.2010.06.004

    authors: Butala P,Greenstein AJ,Sur MD,Mehta N,Sadot E,Divino CM

    更新日期:2010-10-01 00:00:00

  • Comparative analysis of sentinel lymph node operation in male and female breast cancer patients.

    abstract:BACKGROUND:Male breast cancer accounts for < 1% of breast cancers. Sentinel lymph node (SLN) operation is commonly used in the evaluation of female breast cancer patients. The purpose of this study was to determine whether SLN operation is as feasible and accurate in male patients compared with female patients. STUDY ...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2006.06.014

    authors: Boughey JC,Bedrosian I,Meric-Bernstam F,Ross MI,Kuerer HM,Akins JS,Giordano SH,Babiera GV,Ames FC,Hunt KK

    更新日期:2006-10-01 00:00:00

  • Neoadjuvant Locoregional Therapy and Recurrent Hepatocellular Carcinoma after Liver Transplantation.

    abstract:BACKGROUND:Neoadjuvant locoregional therapies (LRTs) have been widely used to reduce tumor burden or to downstage hepatocellular carcinoma (HCC) before orthotopic liver transplantation (OLT). We examined the impact of LRT response on HCC recurrence after OLT. STUDY DESIGN:We performed a retrospective study of 384 pati...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2017.03.015

    authors: Xu M,Doyle MM,Banan B,Vachharajani N,Wang X,Saad N,Fowler K,Brunt EM,Lin Y,Chapman WC

    更新日期:2017-07-01 00:00:00

  • Effect of radiofrequency energy emitted from monopolar "Bovie" instruments on cardiac implantable electronic devices.

    abstract:BACKGROUND:The monopolar "Bovie" instrument emits radiofrequency energy that can disrupt the function of other implanted electronic devices through a phenomenon termed electromagnetic interference. The purpose of this study was to quantify the electromagnetic interference occurring on cardiac implantable devices (CIEDs...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2014.03.060

    authors: Robinson TN,Varosy PD,Guillaume G,Dunning JE,Townsend NT,Jones EL,Paniccia A,Stiegmann GV,Weyer C,Rozner MA

    更新日期:2014-09-01 00:00:00

  • Impact of Autologous Blood Transfusion on Survival and Recurrence among Patients Undergoing Partial Hepatectomy for Colorectal Cancer Liver Metastases.

    abstract:BACKGROUND:Autologous transfusion (AT) has long been considered unsafe in major oncologic operations due to a theoretic risk of spreading metastatic disease, however, few data support this assumption. STUDY DESIGN:We conducted a retrospective analysis of 147 patients who underwent partial hepatectomy for colorectal ca...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2018.10.020

    authors: Kang R,Seath BE,Huang V,Barth RJ Jr

    更新日期:2019-06-01 00:00:00

  • Falls from height: spine, spine, spine!

    abstract:BACKGROUND:Falls from a height are a major cause of morbidity and hospital cost. Spinal injury is frequently associated with falls from height, but reliable predictive factors have not been identified. Diagnostic evaluation of the spine is complex and debated. Our objective was to characterize spinal injury after falls...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2006.07.002

    authors: Velmahos GC,Spaniolas K,Alam HB,de Moya M,Gervasini A,Petrovick L,Conn AK

    更新日期:2006-11-01 00:00:00

  • Factors associated with the quality of patients' surgical decisions for treatment of hip and knee osteoarthritis.

    abstract:BACKGROUND:Shared decision making requires informing patients and ensuring that treatment decisions reflect their goals. It is not clear to what extent this happens for patients considering total joint replacement (TJR) for hip or knee osteoarthritis. STUDY DESIGN:We conducted a cross-sectional mail survey of osteoart...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2013.06.002

    authors: Sepucha K,Feibelmann S,Chang Y,Clay CF,Kearing SA,Tomek I,Yang T,Katz JN

    更新日期:2013-10-01 00:00:00

  • Hospital Resource Use with Donation after Cardiac Death Allografts in Liver Transplantation: A Matched Controlled Analysis from 2007 to 2011.

    abstract:BACKGROUND:Although donation after cardiac death (DCD) liver allografts have been used to expand the donor pool, concerns exist regarding primary nonfunction and biliary complications. Our aim was to compare resource use and outcomes of DCD allografts with donation after brain death (DBD) liver allografts. STUDY DESIG...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2015.01.052

    authors: Singhal A,Wima K,Hoehn RS,Quillin RC 3rd,Woodle ES,Paquette IM,Paterno F,Abbott DE,Shah SA

    更新日期:2015-05-01 00:00:00

  • Oral calcium supplements to enhance early hospital discharge after bilateral surgical treatment of the thyroid gland or exploration of the parathyroid glands.

    abstract::One hundred and seventy consecutive patients undergoing parathyroid gland exploration and bilateral thyroidectomy received, postoperatively, routine oral calcium supplementation, close monitoring of total serum calcium, and addition of vitamin D for specific criteria, all to accomplish a postoperative course free of s...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:

    authors: Moore FD Jr

    更新日期:1994-01-01 00:00:00

  • Congenital stenosis of the intrahepatic bile duct associated with choledochal cysts.

    abstract:BACKGROUND:There are few studies that report on stenosis of the intrahepatic bile ducts associated with choledochal cysts. We investigated the presence and clinical significance of stenosis of the intrahepatic bile ducts associated with choledochal cysts. STUDY DESIGN:We examined intrahepatic bile ducts in patients wi...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:

    authors: Ando H,Ito T,Kaneko K,Seo T

    更新日期:1995-11-01 00:00:00

  • Quantification of duodenogastric reflux in patients with choledochoduodenostomy.

    abstract:BACKGROUND:Frequently, patients present with symptoms after cholecystectomy (pain or discomfort in the upper part of the abdomen, postprandial fullness, bile vomiting, among others). Duodenogastric reflux has been associated with these symptoms in some patients. Therefore, this study was done to investigate this relati...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:

    authors: Lujan-Mompean JA,Torralba-Martinez JA,Parrilla-Paricio P,Robles-Campos R,Liron-Ruiz R,Ramirez-Romero P

    更新日期:1994-08-01 00:00:00

  • Improved extubation rates and earlier liberation from mechanical ventilation with implementation of a daily spontaneous-breathing trial protocol.

    abstract:BACKGROUND:Daily spontaneous-breathing trials (SBTs) are promulgated as the best method for assessing readiness for discontinuation of mechanical ventilation. SBT protocols have also been shown to improve outcomes as opposed to wild-type implementation of daily SBT recommendations. Here we determine whether implementat...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2007.08.022

    authors: Robertson TE,Sona C,Schallom L,Buckles M,Cracchiolo L,Schuerer D,Coopersmith CM,Song F,Buchman TG

    更新日期:2008-03-01 00:00:00

  • Nonelective excisional colorectal surgery in English National Health Service Trusts: a study of outcomes from Hospital Episode Statistics Data between 1996 and 2007.

    abstract:BACKGROUND:Nonelective colorectal surgery is associated with substantial patient morbidity and mortality. This study sought to describe the practice of emergency colorectal surgery in the United Kingdom during an 11-year period using the Hospital Episode Statistics (HES) database. STUDY DESIGN:All nonelective admissio...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2009.11.017

    authors: Faiz O,Warusavitarne J,Bottle A,Tekkis PP,Clark SK,Darzi AW,Aylin P

    更新日期:2010-04-01 00:00:00

  • Trocar injuries in laparoscopic surgery.

    abstract:BACKGROUND:Disposable trocars with safety shields are widely used for laparoscopic access. The aim of this study was to analyze risk factors associated with injuries resulting from their use as reported to the Food and Drug Administration. STUDY DESIGN:Manufacturers are required to report medical device-related incide...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/s1072-7515(01)00913-9

    authors: Bhoyrul S,Vierra MA,Nezhat CR,Krummel TM,Way LW

    更新日期:2001-06-01 00:00:00

  • A novel technique for natural orifice endoscopic full-thickness colon wall resection: an experimental pilot study.

    abstract:BACKGROUND:Natural orifice endoscopic full-thickness colon resection attempts to overcome the need for invasive surgery in selected colorectal indications. Because basic technical requirements have not been met so far, the aim of this study was to develop a novel technique for endolumenal colon-wedge resection addressi...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2011.05.015

    authors: Rieder E,Martinec DV,Dunst CM,Swanström LL

    更新日期:2011-09-01 00:00:00

  • Impact of the New Kidney Allocation System on Perioperative Outcomes and Costs in Kidney Transplantation.

    abstract:BACKGROUND:In December 2014, a new kidney allocation system (KAS) was implemented nationwide with the goal of improving longevity matching, increasing access to sensitized patients, and improving racial/ethnic disparities. STUDY DESIGN:National cohort study of US kidney transplantation programs, analyzing hospital-lev...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2016.12.009

    authors: Taber DJ,DuBay D,McGillicuddy JW,Nadig S,Bratton CF,Chavin KD,Baliga PK

    更新日期:2017-04-01 00:00:00

  • Predictors of comprehension during surgical informed consent.

    abstract:BACKGROUND:Patient comprehension during surgical informed consent remains problematic. Using data from our randomized trial of methods to improve informed consent comprehension, we performed an additional analysis to define independent factors associated with improved patient understanding. STUDY DESIGN:Patients sched...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.jamcollsurg.2010.02.049

    authors: Fink AS,Prochazka AV,Henderson WG,Bartenfeld D,Nyirenda C,Webb A,Berger DH,Itani K,Whitehill T,Edwards J,Wilson M,Karsonovich C,Parmelee P

    更新日期:2010-06-01 00:00:00

  • Emergency laparoscopic management of perforated sigmoid diverticulitis: a promising alternative to more radical procedures.

    abstract:BACKGROUND:Classic emergency surgical management of complicated perforated sigmoid diverticulitis is based on the principle of a two-stage operation, with colon resection and temporary stoma (Hartmann's procedure). But the later second-stage operation can be technically difficult and can be associated with a significan...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2007.11.018

    authors: Bretagnol F,Pautrat K,Mor C,Benchellal Z,Huten N,de Calan L

    更新日期:2008-04-01 00:00:00

  • Postoperative ileus-related morbidity profile in patients treated with alvimopan after bowel resection.

    abstract:BACKGROUND:Postoperative ileus (POI), an interruption of coordinated bowel motility after operation, is exacerbated by opioids used to manage pain. Alvimopan, a peripherally acting mu-opioid receptor antagonist, accelerated gastrointestinal (GI) recovery after bowel resection in randomized, double-blind, placebo-contro...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.jamcollsurg.2007.01.041

    authors: Wolff BG,Weese JL,Ludwig KA,Delaney CP,Stamos MJ,Michelassi F,Du W,Techner L

    更新日期:2007-04-01 00:00:00

  • Decision making in palliative surgery.

    abstract:BACKGROUND:Palliative surgery for advanced cancer patients involves complex decision making. Surgeons with a cancer-focused practice were surveyed to determine the extent to which palliative surgery was currently practiced, to identify ethical dilemmas and barriers they faced in performing palliative surgery, and to ev...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/s1072-7515(02)01306-6

    authors: McCahill LE,Krouse RS,Chu DZ,Juarez G,Uman GC,Ferrell BR,Wagman LD

    更新日期:2002-09-01 00:00:00

  • Initiation of a critical pathway for pancreaticoduodenectomy at an academic institution--the first step in multidisciplinary team building.

    abstract:BACKGROUND:Pancreaticoduodenectomy (PD) is a complex general surgical procedure originally associated with significant perioperative morbidity and mortality. Multiple studies have now shown that this operation can be performed quite safely at high-volume institutions that develop a particular expertise. Critical pathwa...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2007.01.057

    authors: Kennedy EP,Rosato EL,Sauter PK,Rosenberg LM,Doria C,Marino IR,Chojnacki KA,Berger AC,Yeo CJ

    更新日期:2007-05-01 00:00:00

  • Risk adjustment of the postoperative mortality rate for the comparative assessment of the quality of surgical care: results of the National Veterans Affairs Surgical Risk Study.

    abstract:BACKGROUND:The National Veterans Affairs Surgical Risk Study was designed to collect reliable, valid data on patient risk and outcomes for major surgery in the Veterans Health Administration and to report comparative risk-adjusted postoperative mortality rates for surgical services in Veterans Health Administration. S...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章,多中心研究

    doi:

    authors: Khuri SF,Daley J,Henderson W,Hur K,Gibbs JO,Barbour G,Demakis J,Irvin G 3rd,Stremple JF,Grover F,McDonald G,Passaro E Jr,Fabri PJ,Spencer J,Hammermeister K,Aust JB

    更新日期:1997-10-01 00:00:00

  • Isolated liver metastases from neuroendocrine tumors: does resection prolong survival?

    abstract:BACKGROUND:Neuroendocrine tumors commonly metastasize to the liver. Although surgical resection is considered a treatment option for patients with localized metastases confined to the liver, the longterm survival benefit of liver resection has not been clearly demonstrated. We examined the survival of patients undergoi...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/s1072-7515(98)00099-4

    authors: Chen H,Hardacre JM,Uzar A,Cameron JL,Choti MA

    更新日期:1998-07-01 00:00:00

  • Multimodal Analgesic Strategies for Trauma: A Pragmatic Randomized Clinical Trial.

    abstract:INTRODUCTION:An effective strategy to manage acute pain while minimizing opioid exposure is needed for injured patients. In this trial, we aimed to compare two multimodal pain regimens (MMPR) in minimizing opioid exposure and relieving acute pain in a busy, urban trauma center. METHODS:This was an unblinded, pragmatic...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2020.12.014

    authors: Harvin JA,Albarado R,Thanh Truong VT,Green C,Tyson JE,Pedroza C,Wade CE,Kao LS,MAST Study Group.

    更新日期:2020-12-29 00:00:00

  • Long-term outcomes of patients with nonsurgically managed uncomplicated appendicitis.

    abstract:BACKGROUND:Emerging literature has supported the safety of nonoperative management of uncomplicated appendicitis. STUDY DESIGN:Patients with emergent, uncomplicated appendicitis were identified by appropriate ICD-9 diagnosis codes in the California Office of Statewide Health Planning and Development database from 1997...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2014.01.003

    authors: McCutcheon BA,Chang DC,Marcus LP,Inui T,Noorbakhsh A,Schallhorn C,Parina R,Salazar FR,Talamini MA

    更新日期:2014-05-01 00:00:00

  • Liver Function Assessment Using Technetium 99m-Galactosyl Single-Photon Emission Computed Tomography/CT Fusion Imaging: A Prospective Trial.

    abstract:BACKGROUND:The prediction of postoperative liver function remains a largely subjective practice based on CT volumetric analysis. However, future liver volume after a hepatectomy is not the only factor that contributes to postoperative liver function and outcomes. STUDY DESIGN:In this prospective trial, 185 consecutive...

    journal_title:Journal of the American College of Surgeons

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.jamcollsurg.2017.08.021

    authors: Okabayashi T,Shima Y,Morita S,Shimada Y,Sumiyoshi T,Sui K,Iwata J,Iiyama T

    更新日期:2017-12-01 00:00:00

  • Caval inflow to the graft: a successful way to overcome diffuse portal system thrombosis in liver transplantation.

    abstract::Portal vein thrombosis was considered to be a major contraindication to liver transplantation before the introduction of vessel grafts from the recipient's area of confluence of the splenic and superior mesenteric veins, behind the neck of the pancreas, to the graft's portal vein. Refinement in surgical technique has ...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/s1072-7515(99)00299-9

    authors: Azoulay D,Hargreaves GM,Castaing D,Bismuth H

    更新日期:2000-04-01 00:00:00

  • Hepatic resection for the carcinoid syndrome in patients with severe carcinoid heart disease: does valve replacement permit safe hepatic resection?

    abstract:BACKGROUND:Hepatic resection of metastatic carcinoid cancer can prolong survival and control symptomatic endocrinopathy. Decompensated carcinoid heart disease (CHD) can develop in some patients with metastatic carcinoid cancers, which can preclude operation for resectable hepatic metastases. We hypothesized that outcom...

    journal_title:Journal of the American College of Surgeons

    pub_type: 杂志文章

    doi:10.1016/j.jamcollsurg.2011.03.029

    authors: Lillegard JB,Fisher JE,Mckenzie TJ,Que FG,Farnell MB,Kendrick ML,Donohue JH,Reid-Lombardo K,Schaff HV,Connolly HM,Nagorney DM

    更新日期:2011-07-01 00:00:00