The standard of care following gynecologic oncology surgery may include post-discharge calls to patients from gynecologic oncology nurses to assess and suggest interventions as needed during recovery. The high volume of patients at one institution prompted researchers to examine whether an automated text messaging program and other healthcare innovation strategies, instead of standard telephone-based nursing assessments, could provide post-operative patient evaluations that were complete, acceptable to patients, and reduced the clinical workload for providers.
Text Message-Based Assessments
Researchers enrolled English-speaking patients having surgery with four providers in the division of gynecologic oncology at a single center from February-June 2021. They offered patients the standard telephone evaluation with a gynecologic oncology nurses or text message-based assessments. The study team texted patients 48 hours after discharge using an algorithm based on the center’s standard telephone script and employed a “fake back end”—a care team member who sent and responded to patient text messages. Individuals who did not respond were called by the nursing team to finish the outstanding questions, and patients whose replies required additional information were called by the nursing team. Throughout the course of the study, the algorithm was revised based on patient and provider feedback.
The program included 56 enrollees with a median age of 54. The most frequent reason for refusing the program was a patient’s preference for a phone call.
Among enrollees, 41 (73%) started the program, and 18 (44%) finished the entire algorithm. Median time to completion of the algorithm was 34 minutes, and the completed algorithms saved approximately 4.5 hours of provider time. Reasons for failing to finish the algorithm included lack of patient response (65%), having a response that suggested the need for a provider’s evaluation (22%), and algorithm error (13%).
Patients With Gynecologic Cancers Satisfied With Text Messaging Program
In total, 17 enrollees answered the following question: “On a scale of 0-10, how likely are you to recommend this texting program to a friend if they were getting the same procedure as you?” Results included 13 promoters (9-10), one neutral participant (7-8), and three detractors (6 or less). Twelve patients issued a score of 10/10; the lowest score, a 5, came from a single patient.
The results of the pilot program demonstrated that text messaging programs for gynecologic oncology patients are feasible for offering efficient postoperative care that is also satisfactory to patients, according to the researchers. They also noted that future research should examine the safety and scalability of automated text messaging platforms for patient evaluations.
