Creating Digital CarePrograms for ERAS Protocol

Originall published on Doctella Blog – Aug 25, 2017

Mobile health is a rapidly advancing field. It is a buzzword that is thrown around quite a bit in healthcare today that promises the union of high technology and brilliant healthcare to improve outcomes, give greater visibility to patient vitals and statistics, improve research insights, enhance diagnostics and more. How do you stay ahead of the curve and keep up with your patients and peers, especially when it can be extremely costly in terms of capital and time to create a mobile app for patient engagement? Furthermore, it is not simply enough to create an app to say you’ve done so; how do you manage increasing expectations from patients, government standards, competition, etc.? How do you consolidate the overwhelming amount of demands that come from increasingly active patients who use multiple sources of knowledge online as well as other applications for trackables, wearables, etc. and take charge of the information they consume?

After accounting for EMR/EHR integration, medical workflow automation, Medicare and Medicaid standards implementation, trackable integration, high quality customizable medical content, patient-doctor interactability and communication infrastructure, data analytics, long-term maintenance, and most importantly, security, the cost can be astronomical. This is a subject that we will look into further detail in a future post.

This is the first edition of our series spotlighting the Doctella CareProgram, its benefits and some of our most successful users. Available as a web and native mobile app on iOS and Android, Doctella is built to solve all of these problems quickly, easily, and in a cost-effective manner. Our vision consists of safer, more engaged patients coupled with more satisfied providers who have a decreased unnecessary workload and greater visibility and control over patient compliance and satisfaction with care. We hope to contribute to lower complication rates, readmission rates, etc.

Here, we’ll look at how one surgeon easily took a well-respected protocol and successfully incorporated it into our mobile platform to create tangible changes with his patients and staff within a few weeks.

Dr. Martin Paul is a general surgeon at Sibley Memorial Hospital, a member of Johns Hopkins Medicine. He incorporates the Enhanced Recovery After Surgery (ERAS) Protocol with all of his patients. Dr. Paul was able to take Doctella surgery templates and easily incorporate and customize his own information using the Doctella Studio, as well as add ERAS protocol to give to his patients. ERAS is a patient-centered, evidence-based, multidisciplinary team developed set of pathways for efficient and more effective recovery after surgery. The main components of Doctella that Dr. Paul utilizes are:

  1. The education function for patient/family education, laying out a pain management plan, discharge planning, pre and post-operative diet, etc.
  2. Timed alerts and reminders for pre-op testing/clearances, skin preparation and sanitization before surgery, bowel preparation, medication protocol, early mobilization during recovery, follow up with the surgeon, etc.
  3. The provider dashboard for monitoring ERAS compliance for early intervention if needed, monitoring symptoms or changes in health to seek assistance, obtaining and administering quality measures and patient surveys, etc.


Example of Patient Surgery Timeline Planner

Example of Patient Education

Example of Timed Alerts and Reminders

Example of Provider Dashboard (fake patients for privacy purposes)

Dr. Paul has integrated this into his already existing protocols with very little disruption. When a patient comes in for a consultation and a surgery is planned, Dr. Paul’s nurse will send a Doctella CareProgram to them to get started on the education. Once a surgery date is set, the Surgery Scheduler will add this to the patient’s CareProgram, which will enable the alerts and reminders. Finally, Dr. Paul’s nurse has set notifications to alert her if a patient is off track and she needs to intervene. Patients have been extremely active using this platform, as it supplements the documents and materials already distributed and makes it easier to digest and use.

Over the past 5 to 6 months, Dr. Paul has shared over 80 CarePrograms with patients, this only accounting for one surgery: Laparoscopic Colectomy. He has just recently rolled out more CarePrograms to include his other surgeries and is excited to see results on a greater scale. Since implementation, Dr. Paul’s staff has reported a noticeable drop in phone calls with questions that are answered within the CareProgram, an increase in satisfaction of care from patients who enjoy the alerts and reminders and help keep them on track, and an overall increase in satisfaction from staff who do not feel as overwhelmed with their clinical load. Dr. Paul’s staff have enjoyed using Doctella so much, they have urged other surgeons in the practice to begin using the platform for their procedures which have recently been implemented. This took only about one week to do, as they were able to quickly copy Dr. Paul’s CarePrograms and make small modifications. The surgeons and staff at Foxhall are excited, as they are able to administer the same content, education, and standards of care, easily. Doctella has allowed patients to have the same standard of care when going to a practice, yet the personal touch of their individual doctor.

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