Digital solution for follow-up in congenital cardiac surgery.

Abstract

BACKGROUND\nIn this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up.\n\n\nOBJECTIVES\nAs 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.\n\n\nMETHODS\nDischarge 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.\n\n\nRESULTS\nOverall, 3345\xa030-day and 2563\xa01-year surveys were sent between October, 2016 and June, 2020. Of 3345\xa030-day surveys, there were 3191 responses (95%). Of 2563\xa01-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.\n\n\nCONCLUSIONS\nDisCo 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.