Post Operative Survey Through a Bi-Directional Secure Mobile Messaging System
Condition: Pain
Study type: Interventional

Summary: 
      -  Purpose The general purpose of this project is to assess the utility of the mCare
           application and MHCE (Mobile Healthcare Environment) system - a secure, mobile,
           smartphone app based platform - for same day surgery postoperative follow up of patients
           receiving peripheral nerve blocks.

        -  Research Design Randomized open-label study, comparing the satisfaction of the two
           groups with the method of follow up, which is either over the phone or via a mCare
           application. A separate group made up of nurses and physicians will have the opportunity
           to take a short anonymous survey to rank their opinion on the use of the smartphone
           application for patient feedback.
    

Detailed description: 
      The primary objective of the study is to evaluate the feasibility of the implementation of
      the mCare system for postoperative follow-up and querying of patients receiving peripheral
      nerve blocks during their perioperative care. The investigators intend to perform a
      randomized pilot study comparing mCare with the current standard of care. Participants will
      be randomized into 2 groups: a) standard of care groups and b) mCare group. In the standard
      of care group, the participants will be followed-up via a phone call by an Acute Pain Service
      (APS) nurse, according to current standards. During the past year there have been 375 calls
      made, 64 of which have not been answered (17%). In the mCare group participants will be
      followed-up via mCare application. 48 hours after discharge an APS nurse is going to call the
      participants in group a) and the mCare system will notify participants in group b) to answer
      follow-up questions about their pain and peripheral nerve block. If necessary (based on the
      follow-up algorithm), participants in either group will be contacted (via phone call or the
      app, depending on group assignment) 7 days after their surgery to assess resolution of the
      peripheral nerve block. At the end of follow-up, on postoperative day 8, each patient will be
      asked to complete the satisfaction and convenience surveys. 10 days after their surgery
      participants in the mCare group will complete the System Usability Survey (SUS).At the end of
      the study, APS nurses and medical providers will be asked to complete the satisfaction and
      convenience surveys, and follow-up response data will be summarized and analyzed. Our
      research question is whether the use of the mCare system would result in improved patient
      compliance, satisfaction, and convenience on both the patient and the provider side, while
      being at least as safe as the standard of care.

      Research question 1: Does the use of mCare app improve postoperative follow-up response rate
      of patients receiving perioperative peripheral nerve blocks who are discharged the same day?

      Research question 2: Does satisfaction, convenience and ease of use differ between the mCare
      system and current standards a) in the patient population and b) among health care providers?

      The pain assessment tool adapted for the mCare app will be the Defense and Veterans Pain
      Rating Scale(DVPRS),which is a 6 item questionnaire for assessing current pain, average and
      worst pain over the last 24 hours, and physical and emotional function. The DVPRS has been
      validated at Walter Reed National Military Medical Center (WRNMMC), but the administration
      has been paper based during rounds by the Acute Pain Service.

      The current standard for follow up with patients who receive regional anesthesia for same day
      surgery is that the APS nurse contacts them 48 hours after the procedure and asks about their
      pain, qualities and duration of the nerve block, and their satisfaction with the service. If
      the patient's answers make it necessary (e.g. the block doesn't wear off, the numbness still
      persists) then the APS nurse calls them again one week after the surgery. If the numbness
      still persists at that point, then the APS nurse escalates their case by informing the
      regional anesthesia provider who decides further steps.

      In this study, the investigators intend to substitute the phone call by the APS nurse with
      the use of the mCare app. Our research question is whether the app is at least as safe as the
      standard of care, and at least as easy to use and convenient as the phone call.
    

Intervention name(s): Phone Call; Mobile App Survey
Intervention type(s): Other; Other
Intervention description(s): Participants will be followed-up via phone call by Acute Pain Research Nurse; Participants will be followed-up via mCare mobile app
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Health Services Research
Keywords: mCare; post surgery; mobile; healthcare; application