Ileostomies are a routine part of the care of patients with rectal cancer, but are associated with significant risk for dehydration, readmission, and acute kidney injury.
Telemedicine has proven beneficial in decreasing readmission in chronic medical illnesses, but its utility in patients with an ileostomy is not well studied.
Dr Brian Bednarski and colleagues evaluated the feasibility of televideoconferencing in the assessment of ileostomy output.
The team conducted an institutional review board-approved, prospective clinical trial at a single institution from 2014 through 2015.
The researchers evaluated patients >18 years of age undergoing surgery with plans for ileostomy.
Televideoconference assessments of ileostomy output and the need for medical intervention were conducted during the postoperative stay and compared with in-person assessment.
The team's primary end point of the trial was the feasibility of using teleconferencing to assess the need for medical intervention, defined as 90% agreement between telemedicine and in-person assessments.
|The readmission rate for the study participants was 31%|
|Diseases of the Colon & Rectum|
Secondary end points included patient/provider satisfaction, and correlative studies examined dehydration events and readmission.
The researchers reported that 27 patients underwent 44 teleconferencing assessments of ileostomy output.
Compared with in-person treatment decisions, there was a 95% match.
The research team found that readmission rate for the study participants was 31%, and 18% experienced dehydration events.
Both patients and faculty responded favorably to surveys regarding the use of telemedicine in the perioperative period.
Dr Bednarski's team concludes, "Televideoconference evaluation is a feasible, reliable means of assessing ileostomy output with high patient and physician acceptance."
"Our pilot study provides rationale for further study in the postdischarge setting for patients with ileostomies."
"The incorporation of televideoconference assessment within a teledischarge program may enable early intervention to improve patient outcomes."