Background/Objectives: Colorectal cancer (CRC) ranks third in the Western world in cancer incidence and second as the cause of cancer-related deaths. Despite advances in perioperative care, minimizing postoperative morbidity is crucial in clinical practice. Digitalization of the healthcare process plays a key role in genuinely and effectively engaging patients. Our aim was to evaluate a digital solution for remote monitoring of patients with CRC, from surgery indication to postoperative discharge.Methods: We developed a digital solution using Value Stream Mapping (VSM) to identify patient care flow and Lean Sigma for optimization and efficiency. We incorporated the Enhanced Recovery After Surgery (ERAS)/RICA pentamodal recommendations to create a program with an individualized schedule for each patient, who received tailored educational, medical, and practical information at every stage of the process.Results: A total of 193 patients used the digital solution, with >75% adhering to ERAS recommendations. The median length of hospital stay was 5 days, with low adherence leading to 3.4 (p= 0.628) or 3.27 (p= 0.642) extra days in the hospital compared to patients with intermediate and high adherence, respectively. The mean comprehensive complication index (CCI) was 9.1/100, which was higher in patients with low adherence (15) versus intermediate (8.17;p= 0.027) and high (7.42;p= 0.011) adherence. An increase in self-perception of quality of life by 9.2% was identified at the end of the process compared to the outcome at the beginning (p= 0.09), and 80% rated their overall satisfaction with the care process as 8 or higher out of 10.Conclusions: The digital solution facilitates the monitoring of CRC care and implementation and adherence to ERAS recommendations, improving patient engagement and satisfaction.
背景/目的：结直肠癌（CRC）在西方世界的癌症发病率中位居第三，是癌症相关死亡的第二大原因。尽管围手术期护理有所进展，但最大限度地减少术后并发症在临床实践中至关重要。医疗流程的数字化在真正有效地吸引患者参与方面发挥着关键作用。我们的目标是评估一种用于远程监测结直肠癌患者的数字化解决方案，涵盖从手术指征到术后出院的全过程。 方法：我们利用价值流图（VSM）识别患者护理流程，并采用精益六西格玛方法进行优化和提升效率，从而开发出一套数字化解决方案。我们整合了加速康复外科（ERAS）/RICA五模式推荐方案，创建了一个为每位患者提供个性化日程安排的项目。患者在流程的每个阶段都能接收到量身定制的教育、医疗及实用信息。 结果：共有193名患者使用了该数字化解决方案，其中超过75%的患者遵循了ERAS推荐方案。中位住院时间为5天。与依从性中等和较高的患者相比，低依从性患者的住院时间分别额外增加了3.4天（p=0.628）和3.27天（p=0.642）。平均综合并发症指数（CCI）为9.1/100分，其中低依从性患者的CCI（15分）显著高于中等依从性（8.17分；p=0.027）和高依从性患者（7.42分；p=0.011）。流程结束时，患者自评生活质量较开始时提升了9.2%（p=0.09），且80%的患者对整体护理流程的满意度评分达到8分或以上（满分10分）。 结论：该数字化解决方案有助于监测结直肠癌护理过程，促进ERAS推荐方案的执行与遵循，从而提升患者参与度和满意度。
Preliminary Outcomes of a Digital Remote Care Solution for Colorectal Cancer Patients
肿瘤(癌症)患者之家