Information technology-based joint preoperative assessment, risk stratification and its impact
DISCOVERIES (ISSN 2359-7232), 2021, April-June issue
Submitted: April 04, 2021; Revised: April 23, 2021; Accepted: May 08, 2021; Published: June 30, 2021;
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Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost
Habib Md Reazaul Karim (1), Subrata Kumar Singha (1), Praveen Kumar Neema (1), Tridip Dutta Baruah (2), Rubik Ray (2), Debajyoti Mohanty (2), Md Sabah Siddiqui (3), Rachita Nanda (4), Narendra Kuber Bodhey (5)
(1) Department of Anaesthesiology, (2) Department of General Surgery, (3) Department of General Medicine, (4) Department of Clinical Biochemistry, (5) Department of Radiodiagnosis, All India Institute of Medical Sciences, Raipur, India
*Corresponding authors: Habib Md Reazaul Karim, MD, DNB, IDCCM, FNIV, Faculty Room A001, Block A, AIIMS Hospital Complex, Raipur, India. Email: drhabibkarim@gmail.com; Phone: +91-9612372585; ORCID: https://orcid.org/0000-0002-6632-0491
Abstract
Background: Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing’s impact on patient outcome and cost.
Methods: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant.
Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications.
Conclusion: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.
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