The Effect of a 30-day Automated Text Messaging Intervention on Hospital Based Acute Care Encounters Following Ileostomy
| Status: | Terminated |
|---|---|
| Healthy: | No |
| Age Range: | 18 - 90 |
| Updated: | 4/6/2019 |
| Start Date: | March 1, 2018 |
| End Date: | March 31, 2019 |
Each year a large number of patients undergo ileostomy surgery, a procedure in which a
portion of the small intestine is attached to a hole in the abdominal wall, allowing for
digested material to pass into a disposable bag worn attached to the skin. Ileostomies are
performed for the treatment of a variety of diseases of the intestinal tract, such as
inflammatory bowel disease, intestinal trauma, and gastrointestinal malignancy. Of the
patients that undergo ileostomy surgery, 36% will require urgent medical care within the
first 30 days of surgery. Most frequently, this is a result of dehydration due to excessive
ostomy output. Thus, there is potential for significant improvement of the post-operative
outcomes of ileostomy patients. Implementation of an automated text messaging system,
EpxOstomy, can provide a way of monitoring patient's daily ostomy output and allow for timely
intervention if output is outside normal limits, providing an effective way of improving
patient outcomes while simultaneously reducing healthcare costs.
portion of the small intestine is attached to a hole in the abdominal wall, allowing for
digested material to pass into a disposable bag worn attached to the skin. Ileostomies are
performed for the treatment of a variety of diseases of the intestinal tract, such as
inflammatory bowel disease, intestinal trauma, and gastrointestinal malignancy. Of the
patients that undergo ileostomy surgery, 36% will require urgent medical care within the
first 30 days of surgery. Most frequently, this is a result of dehydration due to excessive
ostomy output. Thus, there is potential for significant improvement of the post-operative
outcomes of ileostomy patients. Implementation of an automated text messaging system,
EpxOstomy, can provide a way of monitoring patient's daily ostomy output and allow for timely
intervention if output is outside normal limits, providing an effective way of improving
patient outcomes while simultaneously reducing healthcare costs.
Each year thousands of patients undergo ostomy surgery in the treatment of diseases such as
colorectal cancer, Crohn's disease, diverticulitis, and ulcerative colitis. During the 30-day
post-operative period, patients that undergo ileostomy have a 36.1% rate of acute healthcare
encounter compared to 16.2% of patients undergoing similar surgery but with primary
anastomosis. The 30-day hospital readmission rate for ileostomy patients due to dehydration
and renal failure is 17%, with the median cost per colorectal surgery readmission being
$8,885. Thus, there is substantial room for post-operative improvement in the care of
ileostomy patients, both to reduce healthcare costs and improve patient quality of life. An
automated text messaging system can provide a way to consistently monitor patients' ileostomy
output, ensuring that patients are measuring their daily output as instructed and allowing
for timely preemptive intervention should output be outside normal limits.
colorectal cancer, Crohn's disease, diverticulitis, and ulcerative colitis. During the 30-day
post-operative period, patients that undergo ileostomy have a 36.1% rate of acute healthcare
encounter compared to 16.2% of patients undergoing similar surgery but with primary
anastomosis. The 30-day hospital readmission rate for ileostomy patients due to dehydration
and renal failure is 17%, with the median cost per colorectal surgery readmission being
$8,885. Thus, there is substantial room for post-operative improvement in the care of
ileostomy patients, both to reduce healthcare costs and improve patient quality of life. An
automated text messaging system can provide a way to consistently monitor patients' ileostomy
output, ensuring that patients are measuring their daily output as instructed and allowing
for timely preemptive intervention should output be outside normal limits.
Inclusion Criteria:
- Patients between 18-90 years of age with phone or text receiving device access.
- English speaking
- Patients undergoing ileostomy surgery
Exclusion Criteria:
- Patients who do not have phone or text receiving device access
- Patients mentally unable to provide consent for the study
- Patients who do not speak English
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