Remote Symptom Monitoring in Thoracic Surgery Patients After Discharge

Objective: Evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms. Summary Background Data: Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration. Methods: An online symptom-tracking platform for thoracic surgery patients was created on the basis of opinions from stakeholders and a review of the literature. Starting in February 2021, patients were educated about the symptom tracker in preoperative clinics. After discharge, patients received a series of electronic surveys covering 23 symptom domains assessed using a Likert scale for severity. Moderate symptoms prompted a “yellow alert,” and severe symptoms prompted a “red alert,” both notifying the nursing team and prompting appropriate action. Patients were considered responders if they completed at least 1 survey. Results: In total, 1997 patients were enrolled; 76% (n=1520) were responders. Responders were younger, more likely to be White, less likely to have medical comorbidities, and less likely to be readmitted (odds ratio, 0.53 [95% CI, 0.37-0.76]; P <0.001). Responders who were readmitted had a higher percentage of red alerts (47% vs. 24%; P <0.001) and yellow alerts (74% vs. 61%; P =0.016), compared with responders who were not readmitted. Conclusions: Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.