title: Utility of routine postoperative visit after appendectomy and cholecystectomy with evaluation of mobile technology access in an urban safety net population.
abstract: BACKGROUND
  The value of routine postoperative visits after general surgery remains unclear. The objective of this study was to evaluate the utility of routine postoperative visits after appendectomy and cholecystectomy and to determine access to mobile technology as an alternative platform for follow-up.
  
  
  METHODS
  Retrospective review of 219 appendectomies and 200 cholecystectomies performed at a safety net hospital. One patient underwent both surgeries. Patient demographics, duration of clinic visit, and need for additional imaging, tests or readmissions were recorded. Access to mobile technology was surveyed by a validated questionnaire.
  
  
  RESULTS
  Of 418 patients, 84% percent completed a postoperative visit. At follow-up, 58 patients (14%) required 70 interventions, including staple removal (16, 23%), suture removal (4, 6%), drain removal (8, 11%), additional follow-up (20, 28%), medication action (16, 21%), additional imaging (3, 4%), and readmission (1, 1%). Occupational paperwork (62) and nonsurgical clinic referrals (28) were also performed. Average check-in to check-out time was 100 ± 54 min per patient. One intervention was performed for every 7.8 h of time in the clinic. Additionally, 88% of the surveyed population reported access to cell phone technology, and 69% of patients <40 y had smartphone access.
  
  
  CONCLUSIONS
  Routine in-person follow-up after surgery consumes significant time and resources for patients and healthcare systems but has little impact on patient care. Most of the work done in the clinic is administrative and could be completed using mobile technology, which is pervasive in our population.
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Diane W
authors.initials: DW
authors.lastname: Chen
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Rachel W
authors.initials: RW
authors.lastname: Davis
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center of Excellence, Houston, Texas.
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Balentine
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Scott
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Yue
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Tapia
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center of Excellence, Houston, Texas.
authors.forename: David H
authors.initials: DH
authors.lastname: Berger
authors.affiliation: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas; Houston VA HSR&D Center of Excellence, Houston, Texas. Electronic address: Suliburk@bcm.edu.
authors.forename: James W
authors.initials: JW
authors.lastname: Suliburk
mesh_terms: D000328:Adult; D001062:Appendectomy; D040421:Cell Phone / Q000706:statistics & numerical data; D002763:Cholecystectomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D064876:Safety-net Providers / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Appendectomy; Cholecystectomy; Electronic communication; Mobile; Mobile health; Quality follow-up; Technology