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Digital solution for follow-up in congenital cardiac surgery

Published online by Cambridge University Press:  09 September 2021

Laura Carlson Open the ORCID record for Laura Carlson [Opens in a new window] ,
Jacqueline O’Brien ,
Nitin Gujral ,
Vincent Chiang ,
Pedro del Nido  and
Meena Nathan
Laura Carlson
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA
Jacqueline O’Brien
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA
Nitin Gujral
Affiliation:
Boston Children’s Hospital, Boston, MA, USA Innovation Acceleration Program, Boston Children’s Hospital, Boston, MA, USA
Vincent Chiang
Affiliation:
Boston Children’s Hospital, Boston, MA, USA Department of Emergency Medicine, Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Pedro del Nido
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
Meena Nathan*
Affiliation:
Department of Cardiac Surgery, Boston Children’s Hospital, Boston, MA, USA Boston Children’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA
*
Author for correspondence: M. Nathan, MD, MPH, Department of Cardiac Surgery, Children’s Hospital Boston, 300 Longwood Ave, Bader 273, Boston, MA 02215, USA Tel: (617) 355 7932; Fax: (617) 730 0214. E-mail: [email protected]
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Abstract

Background:

In this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up.

Objectives:

As part of a quality initiative, we developed an automated post-operative follow-up system for patients following discharge after cardiac surgery at Boston Children’s Hospital.

Methods:

Discharge Communication (DisCo) is a web-based system developed at Boston Children’s Hospital. An automated text and e-mail with a link to a health status survey are sent at 30 days and 1 year post-discharge in English/Spanish. If there is no response, surveys are completed via phone calls to the patient/patient’s physician or chart review. Responses are stored in the DisCo database and the patient’s medical record. Patients who underwent cardiac surgery and survived to hospital discharge from October, 2016 received the surveys.

Results:

Overall, 3345 30-day and 2563 1-year surveys were sent between October, 2016 and June, 2020. Of 3345 30-day surveys, there were 3191 responses (95%). Of 2563 1-year surveys, there were 1807 responses (71%). Most patients/families responded directly to the link at 30 days (65% for paediatrics/75% for adults) and at 1 year (72% for paediatrics/78% for adults). Multi-variable logistic regression revealed that higher complexity of cardiac lesion, presence of major non-cardiac anomalies and presence of major residua were associated with readmission and catheter/surgical reinterventions. Non-cardiac anomalies were associated with increased need for services for learning, development or behaviour.

Conclusions:

DisCo provides a successful web-based health status assessment of patients following congenital cardiac surgery. It helps to identify high-risk patients who need closer follow-up.

Keywords

Follow-upcongenital cardiac surgeryelectronic communication
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 7 , July 2022 , pp. 1032 - 1040
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Meeting Presentations: Electronic poster presentation at the Southern Thoracic Surgical Association 66th Annual Meeting, Marco Island, November 2019.

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