Virtual Visits (Utilization of Virtual Care in Postoperative Patients to Improve the Patient Experience)

Study Overview
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Brief Summary
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The purpose of this study is to implement and evaluate postoperative virtual care visits for patients who undergo a laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy. The investigators aim to better understand whether postoperative virtual care visits will not result in a greater composite measure of the occurrence of hospital encounters within Atrium Health (AH) for the 30 days following surgery than standard in-person clinic care. The investigators also aim to better understand whether postoperative virtual care visits provide time and cost savings, and provide equal or improved patient satisfaction and convenience.

Detailed Description
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Participants will be randomized to complete either a postoperative follow-up visit using virtual care technology or by attending a standard in-person visit at the clinic. The virtual visit uses a camera-enabled device and internet access to provide live access to the medical professional. Surveys to assess patient satisfaction and convenience will be administered by email on the day of the postoperative follow-up visit. Additional information including demographics, hospital encounters within 30 days of surgery, length of time of the follow-up visit, travel cost and time, whether additional follow-up care is required, and complications after surgery will be collected to evaluate postoperative virtual care visits. Subject participation in the study will end after follow-up care is complete or at 30 days, whichever occurs last.

Official Title
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Utilization of Virtual Care in Postoperative Patients to Improve the Patient Experience

Conditions
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Cholecystectomy, Robotic, Appendectomy, Laparoscopic, Cholecystectomy, Laparoscopic

Intervention / Treatment
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* Other: Virtual Visit


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Willing to comply with all study procedures and be available for the duration of the study English speaking Able to read Have an email address Scheduled to undergo a laparoscopic appendectomy, laparoscopic cholecystectomy or robotic cholecystectomy OR have undergone an unplanned (urgent or emergent) laparoscopic appendectomy, laparoscopic cholecystectomy, or robotic cholecystectomy Have surgery performed by a surgeon at either Carolinas Medical Center-Main or Carolinas Medical Center- Mercy who provides emergency general surgery clinical coverage Live in North Carolina or South Carolina Exclusion Criteria: Unable to complete a virtual visit (due to lack of appropriate technology, necessary technology skills, other); Medical condition, laboratory finding, or physical exam finding that precludes participation (patients at high risk for complications, particularly those with perforated appendicitis, patients with active cocaine abuse) Postoperative length of stay greater than or equal to 4 days Discharged with drains that need to be removed at a postoperative visit Admitted from or discharged to assisted living facility, skilled nursing facility, or location other than home Have chronic pain for which the participant takes narcotic medication

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Virtual Visit Group<br>Participants assigned to the virtual visit group will receive a virtual visit as their postoperative follow-up visit. | Other: Virtual Visit<br>* Participants will be given information about how to enroll in virtual care. Participants will use their own camera-enabled device with internet connection to see and speak to the medical professional in real-time and complete the virtual follow-up visit.<br>|
| No Intervention: Standard In-person Group<br>Participants assigned to the standard in-person group will receive an in-person follow-up visit as their postoperative follow-up visit. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Composite measure of the occurrence of hospital encounters | composite measure of the occurrence of hospital encounters for the 30 days following surgery including all-cause and any-site inpatient, observational, and emergency department visits within Carolinas HealthCare System | from date of surgery until the date of 30 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative follow-up visit time length in minutes | total time of postoperative follow-up visit in minutes | date of follow-up visit, approximately 14 days after date of surgery | 
| Patient satisfaction score | self-reported patient satisfaction rating for follow-up visit assessed by survey | date of follow-up visit, approximately 14 days after date of surgery | 
| Patient convenience score | self-reported patient convenience rating for follow-up visit assessed by survey | date of follow-up visit, approximately 14 days after date of surgery | 
| Rate of postoperative follow-up | percent of patients who receive a postoperative follow-up visit | date of follow-up visit, approximately 14 days after date of surgery | 
| Rate of postoperative no-shows | percent of scheduled postoperative follow-up appointments in which patients do not complete | date of follow-up visit, approximately 14 days after date of surgery | 
| Patient travel time to clinic in minutes | total patient travel time from home to postoperative follow-up clinic in minutes | date of follow-up visit, approximately 14 days after date of surgery | 
| Patient cost savings in dollars | Patient gas cost savings for travel from home to postoperative follow-up clinic | date of follow-up visit, approximately 14 days after date of surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Virtual Visits, Telehealth