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Asynchronous Post-Operative Follow-Up Using App Messaging for In-Office Hand Surgery
Shafic Sraj, MD, MBA
1, Samuel Van Beck, BS
2; Jakub Ratkowski, MD
2(1)West Virginia University, Morgantown, WV, (2)WVU, Morgantown, WV
Hand surgery post-operative follow-up traditionally involves in-person visits. The introduction of HIPPA compliant messaging Apps that are integrated within electronic medical records created an opportunity for message-based follow up. This prospective study evaluates the feasibility of asynchronous post-operative virtual follow-up with a focus on efficacy and patient experience.
Methods:Patients who underwent Wide Awake Local Anesthesia No Tourniquet (WALANT) office-based surgery by a single hand surgeon between June 2024 and November 2024 were screened for inclusion. Adult patients with access and ability to use MyChart app to communicate with their healthcare providers were included. Patients requiring additional in-person care such as postoperative imaging, splinting, or suture removal were excluded. Patients received a standardized post-operative questionnaire and a prompt to submit a picture of their incision seven days following their surgery. Patient responses were reviewed asynchronously by the attending surgeon. A survey inquiring about patient satisfaction with the follow up process was distributed the following week. A chart review was conducted three months postoperatively to identify any post-operative complications or other interactions related to the surgical episode.
Results:Of sixty-three screened patients, 61 were enrolled and 59 completed the post-operative follow-up questionnaire. 54 completed the satisfaction survey. Five patients had additional encounters: three virtual visits and two in-person visits. One patient had a suture abscess and sustained a traumatic wound dehiscence. Two patients provided sub-optimal images of their incision and were asked to submit additional photos. Patient satisfaction on a five-point Likert scale (1=Very Dissatisfied, 5=Very Satisfied) was 4.62. Patient likelihood to recommend asynchronous follow-up on a five-point Likert scale (1=Extremely Unlikely, 5=Extremely Likely) was 4.72.
Summary:Patients report a favorable experience after using asynchronous telehealth technology for their post-operative follow-up after undergoing office surgery. The majority of patients did not require additional scheduled visits. If additional encounters were required, most patient concerns were adequately addressed with a virtual visit. Future studies are needed to determine if there is a difference in patient satisfaction when follow-up is conducted in-person or asynchronously.
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