The more engaged patients are in their care, the more they trust their clinicians, perceive respect from their clinicians, and adhere to treatment plans, which, in turn, improves outcomes and reduces attrition and loss to follow-up. —Emily F. Boss, MD, MPH
Explore This IssueJune 2021
Despite these limitations, she sees the potential benefit of the apps given sufficient education on their quality. “Their application in the clinical practice can bring enormous advantages in diagnosis and treatment of ENT disease, especially in rural and underserved areas,” Dr. Trecca said.
Phone-Based Surgical Reminders
Drilling down deeper, there are some novel uses of phone-based technology that can enhance patient engagement in otolaryngologic practice.
For the many patients who undergo surgical procedures for otolaryngologic conditions, the use of an app to remind them to adhere to surgical protocols both prior to and after surgery can help reduce or avoid altogether the need to reschedule surgery and can potentially lead to improved patient outcomes.
Michael R. Holtel, MD, past chair of the AAO–HNS telehealth committee and an otolaryngologist at Sharp Rees-Stealy Medical Group in San Diego, Calif., who published an early article on cell phones in otolaryngology (Otolaryngol Clin North Am. 2011;44:1351-1358), is working on adapting an app for managing ophthalmology surgical patients. Developed by a Sharp Healthcare team led by his ophthalmologist colleague Tommy Korn, MD, the app moves a patient through the surgical process beginning with a checklist for reminders on what patients need to do prior to surgery (e.g., when to stop eating, setting up transportation). After surgery, the app provides instructions about what patients need to do for postop care, records their medication use, and also includes a way for patients to send photos of their incisions back to the surgeon for review (Figure 1).
The cell phone is often the connecting device that allows us to monitor our patients and intervene at the optimal time while avoiding the need for repeated return clinic visits. —Michael R. Holtel, MD
“Many physician offices use text appointment reminders, but this app provides a more detailed and interactive approach,” said Dr. Holtel, who underscored the utility of the app for both the provider, by reducing the need to cancel surgeries when patients forget to adhere to presurgical protocols, and for the patient, by making it easier to follow surgical protocols.
Based on ophthalmology experience with the app, Dr. Holtel thinks a similar app tailored to otolaryngologic patients will provide similar benefits. Current data on its use in over 300 cataract patients show a lower rate of surgical cancellations. Although no published data are yet available on the app’s effect on postsurgical care, Dr. Holtel said that he thinks the ability to constantly monitor a patient via postsurgical follow-ups will improve care.
He noted that constant monitoring of wearable devices with the addition of machine learning is where medicine, including otolaryngology, is headed. “The cell phone is often the connecting device that allows us to monitor our patients and intervene at the optimal time while avoiding the need for repeated return clinic visits,” he said.