SCREEN TEST Mobile health apps can improve communication between staff and patients while simplifying a number of time-consuming tasks.

In 2017, people expect immediate access to information wherever they go, including the OR — especially the OR, for that matter. And now they can have it. Mobile health apps have helped surgical facilities open the lines of communication in a variety of ways. In addition to providing regular updates to settle the nerves of waiting family members, these apps can simplify a number of time-consuming tasks — everything from procuring pre-admission assessments, to sharing essential pre- and post-op instructions, to sending friendly reminders about coming-due payments (see "Text Patients Before, During and After Surgery" on page 34).

Surgical facilities that invest in these technologies stand to harvest some tangible fruits in terms of patient satisfaction, efficiency and compliance. Apps designed to handle pre-admission assessments, for example, can help you reallocate labor hours so your nurses can focus on clinical care rather than spend hours on the phone. Such benefits do come with a price tag, however. One industry expert estimates the subscription cost at $500 to $1,000 per month, depending on the app. Here are 6 benefits of connecting to your patients using apps.

1Completing pre-admission assessments. When scheduling new patients for surgery, rather than having a preadmission nurse chase them down for their health history and insurance information, apps can do the job for you. Surgical facilities can set up an app's screening process to provide different "alerts" if a patient has a particular concern — fear of anesthesia, for example — or health condition that might affect how care is delivered. Also, some apps offer value-added tools such as the ability to track and store consent forms, labs and other important documents. Some even offer value-added callback services to further free up staff members for more vital tasks.

2Sharing pre-op instructions. How many surgeries are delayed because patients forgot their NPO instructions? You can now use apps to send text messages the night before, reminding patients to refrain from eating or drinking after midnight. Avoid other complications by reminding patients to stop taking blood thinners or other medications in advance of a surgical procedure. What's more, some apps can provide helpful information that has nothing to do with the actual surgery, such as driving directions to the surgical facility and route-specific traffic conditions — even parking options — for smoother visits from start to finish.

3Communicating with family members. Apps that enable perioperative communication between the surgical team and a patient's family members can have a remarkable effect on patient satisfaction. "Physicians say they have to explain a lot less, and family members feel more up to date and involved in the patient's care," says Michelle Tingle, MSN, RN, CNL, CNOR, clinical manager of preadmission and pre-operative services at Sarasota (Fla.) Memorial Hospital. "Even if a surgery is taking a little longer than expected, you can send a text to let the family know, so they're not sitting there and thinking: This is taking too long; something must be wrong."

4Streamlining post-op follow-up. Rather than having a staffer call to follow up with each patient, send video instructions about medications and infection prevention to ensure each patient's speedy recovery. Apps let a post-operative nurse ask how patients are feeling and if they have redness or swelling around the surgical area — and patients can respond by sending photos of the site for prompt review. Some apps even have "chat functions" so staff can speak directly with patients to answer any follow-up questions and ameliorate concerns.

5Taking satisfaction surveys. Many apps send automatic updates asking patients how they would rate their experience at your surgical facility, drilling down into areas such as wait times, communication and overall friendliness. These interactive surveys evolve based on how patients respond, and then facilitate the follow-up process for gathering more in-depth feedback, because patients have an outlet for sharing their voices. This data can then be compiled and analyzed to address any shortfalls in patient care or satisfaction.

6Getting paid. Right now, mobile apps are providing additional safeguards and valuable stand-ins that free up staff for clinical care and other vital tasks. Advances will likely come soon in areas such as payment. Apps already have the capability to remind patients they have an outstanding balance and instruct them who and when to call so they can fulfill their financial obligations, but we could soon see apps that set up payment plans, procure financing services and pay for services with the simple push of a button.

CONSTANT CONTACT
Text Patients Before, During and After Surgery

Here are 6 ways mobile health apps let you stay in touch with patients and their families through their mobile devices

— Compiled by Bill Donahue

One Medical Passport
ONLINE HEALTH HISTORY
Direct patients to complete their health history and provide insurance information so pre-operative nurses can focus on clinical duties.

CareWire
WHEN TO ARRIVE
Keep patients on target for their surgery dates by sharing important pre-op instructions, such as medication and NPO reminders.

EASE Applications
UPDATE FAMILY
Communicate with a patient's family members while their loved one is in surgery to ameliorate concerns during a stressful time.

Twistle
POST-OP CARE
Send video instructions about infection prevention and medication reminders to ensure a patient's speedy recovery.

Jellyfish Health
PATIENT SATISFACTION SURVEYS
Send automatic updates asking patients to rate their experience, while making it easier to follow up for more in-depth feedback.

Simple Admit
CO-PAY REMINDERS
Remind patients of their payment options so they can fulfill their financial obligations promptly, with gentle updates for collecting on outstanding balances.

Apps in action at a hospital
As part of a recent renovation, Sarasota Memorial Hospital moved its surgical waiting room down to the first floor. The relocation provided family members with more physical comforts, but it also created an unforeseen consequence: It added more stress to an already nerve-wracking experience by putting more distance, physically and emotionally, between family members and their loved ones in surgery.

Sarasota Memorial promptly found a solution to "bridge the communication gap," says Ms. Tingle: an app that lets members of the surgical team — the circulating nurse, usually — text surgical updates every 30 to 45 minutes, often with images of X-rays and video messages from the surgeon, to family members on the first floor.

"Dad is safely off to sleep and the surgery is about to begin."

"The hip implant is about to go in."

"We are now on bypass. Mom is doing very well."

Ms. Tingle says family members — even those far beyond the walls of the hospital — appreciate the peace of mind the customized texts provide: "We had a patient who was visiting from Switzerland," she says, "and we were sending updates home to his mom and dad."

The benefits have justified the monthly subscription cost, which Ms. Tingle characterizes as "very reasonable." After some initial resistance to the app, the hospital has since received "overwhelming" positive feedback from staff and patients alike. In fact, the response has been so positive that the hospital is now looking to pilot the app in the ICU for families of extended-stay patients.

'Everyone has a smartphone now'
Cellphones have become invaluable conduits for so many aspects of human life — communication, entertainment and banking, among others. Choosing not to use a tool that lets you engage with patients and their families on their terms could be a missed opportunity.

You might ask, "Well, apps might appeal to younger patients, but what about technology-averse patients of a certain age?" Let Ms. Tingle put your mind at ease.

"Our [older patients] are more tech-savvy than I would have thought," she says. "We were concerned initially because Sarasota typically has an older population, and using an app like the one we did is seen as cutting edge. Everyone has a smartphone now, and the app is very simple to use."

Finally, keep in mind that patient satisfaction is an increasingly valuable currency, especially in light of the Hospital Consumer Assessment of Healthcare Providers and Systems initiative, so any tools designed to keep patients happy could be well worth the investment. Starting this year, 2% of Medicare reimbursement dollars will be tied directly to a hospital's HCAHPS performance. OSM