By Rick Halton, VP Product & Marketing, Lumeon
There has been lots of discussion about an evidence-based approach for helping patients recover more quickly after surgery or clinical procedures. Whilst the evidence has remained largely the same over the last decade, implementation and adoption of enhanced recovery protocols has been slow.
A major reason for this has been the complexity in coordinating care across a number of different care teams and settings. Similarly, positive outcomes are heavily dependent on patients being engaged, having a full understanding of what to expect and what is expected of them, and entering into a ‘contract of care’ partnership with healthcare professionals.
Lumeon’s Care Pathway Management (CPM) is a new digital approach that strives to put the patient firmly at the center of their care, giving them a customized and tailored experience, whilst automating many of the care team’s tasks, allowing them to focus on those patients requiring the most attention.
The guidelines rightly place much emphasis on what happens during and immediately after the operative period. However, just as important to success is how patients are prepared for their surgical experience, and to make sure they are clear about what happens once they get home.
In this post, we explore how CPM supports the automation and scaling of the pre-admission phase of the enhanced recovery pathway. Here are Lumeon’s five top tips for ensuring the patient is in the best possible condition prior to surgery, to ensure the best possible recovery afterwards:
Put patients at ease by keeping them informed
Support the decision-making and consent process by ensuring the patient is as well informed as can be. Sending informative messages in the patient’s preferred language and method (voice, SMS or email) to the patient (or their caregiver) regarding a procedure (e.g. details of the procedure, preparation details) will help them decide whether or not to undergo surgery, and to make sure their expectations are realistic if they choose to do so.
Appropriately triage referrals and create personalized plans of care – fast track versus high-intensity management and monitoring
For patients to achieve the best results, it is vital that assessment starts at the point of referral. CPM facilitates real-time triage of patients to identify those at increased risk of morbidity due to problems like anemia, sub-optimal diabetic control, hypertension, reduced renal function, obesity, smoking and low levels of physical fitness. A personalized management plan is generated to optimize the patient’s condition before surgery becomes a definitive option.
Adapt patient advice based on level of patient activation
Automate and adapt self-management information to help improve patient compliance, by tailoring the advice given based on a patient’s level of knowledge, motivation, health literacy and confidence. For those patients who are not progressing against their stated goals, consider referral to ambulatory based prehabilitation programmes such as smoking cessation, weight reduction and/or exercise programmes.
Assess patient risk using evidence-based scoring and algorithms to help plan intra- and post-op care
CPM is able to risk stratify patients at different stages of the care pathway, allowing timely escalation and the care team to focus on those patients with the highest risk profiles. These assessments can be subjective based on patient feedback e.g. functional status surveys or patient-reported outcome questionnaires or involve more formalized risk scoring e.g. individualized perioperative risk, or risk of delayed discharge.
By understanding the likelihood of downstream problems, care team members can start to proactively plan for a patient’s recovery, e.g. ensure availability of intensive care or high dependency beds for high-risk patients or ensure appropriate multi-disciplinary team assessments are scheduled and completed to facilitate a smooth discharge.
Automate the majority of the pre-operative assessment process, tasking the appropriate care team member by exception
A cohesive pre-operative assessment service is fundamental for the delivery of enhanced recovery. Much of the patient communication and investigations can be automated with CPM using the digitally collated information to decide whether a patient needs to be reviewed in a pre-assessment clinic, and by which level of clinician. This ultimately ensures speedy access to an anesthetist or the appropriate healthcare professional e.g. cardiologist, to review high-risk patients and expedite an appropriate management plan.
If you would like more information about Care Pathway Management and how Lumeon can help you automate and operationalize enhanced recovery after surgery to make it the norm, please get in touch.