Tele-Health Electronic Monitoring to Reduce Post Discharge Complications and Surgical Site Infections
Condition: Peripheral Vascular Disease
MeSH terms: Infections; Surgical Wound Infection; Vascular Diseases; Peripheral Vascular Diseases; Peripheral Arterial Disease
Study type: Interventional

Summary: 
      Abstract:

      It is intuitive that post discharge surgical complications are associated with increased
      patient dissatisfaction, and directly associated with an increase in medical expenditures. It
      is also easy to make the connection that many post hospital discharge surgical complications
      including surgical site infections could be influenced or exacerbated by patient
      co-morbidities. The authors of a recent study reported that female gender, obesity, diabetes,
      smoking, hypertension, coronary artery disease, critical limb ischemia, chronic obstructive
      pulmonary disease, dyspnea, and neurologic disease were all of among significant predictors
      of surgical site infections after vascular reconstruction was performed. The main concern for
      optimal patient care especially in geographically isolated areas of West Virginia is to have
      early, expeditious, and prompt diagnosis of early surgical site infection with subsequent
      indicated interventions. This theme will lead to patient satisfaction, minimizing third party
      interventions and decrease the total cost associated with these complications. Nevertheless,
      it seems reasonable to believe that monitoring using telehealth technology and managing the
      general health care patients receive after a hospital vascular intervention will improve
      overall health and reduce post-operative complications.

      Aims/Objectives:

      1. The primary objective of the current project is to compare early and late outcomes for
      patients who receive post discharge health care monitoring (which includes using Telehealth
      electronic monitoring; THEM) to patients who receive standard of care (SOC) and routine
      discharge instructions and no monitoring.

      Methods:

        1. Randomize patients who are scheduled to have revascularization interventions with groin
           incisions to receive either telehealth electronic health care monitoring or normal
           standard of follow-up care.

        2. Follow patients for 4 weeks, record any 30-day hospital readmissions or complications.
           In addition, have participants complete the follow-up survey questionnaires.
    


Intervention name(s): Tele-Health Electronic Monitoring (THEM)
Intervention type(s): Other
Intervention description(s): Patients in the intervention group (THEM) will receive a tablet computer and home monitoring medical devices with sensors to transmit the information to a central website that will be monitored by care managers. Medical devices will include weight scales, blood pressure cuffs and blood glucometers. Clinical care mangers will remotely monitor the patients and all electronic readings. Clinical care managers will call or send text messages to the patients based on alerts generated by the tele-health monitoring system.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: surgical site infection