Preoperative Patient Communication Method and Its Impact on Post Operative Outcomes and Healthcare Utilization Following Cystectomy.

OBJECTIVE

To evaluate if utilization of secure patient portal messaging platform such as MyChart are associated with improved postoperative outcomes following cystectomy and how this compares to telephone utilization.

METHODS

Patients undergoing cystectomy at our institution between 2016-2022 were included. MyChart messages and telephone calls within one month preoperatively were collected. Users were defined as patients initiating contact via secure message or telephone call prior to surgery. Postoperative complications, emergency department visits, and readmissions were recorded, and a composite measure of the three was generated. We stratified by MyChart users, phone users, combination users, and non-users. Statistical analysis was performed with t-test, Kruskal-Wallis, chi-squared, and Fisher's exact tests, and multivariable logistic regression.

RESULTS

The final population was 244 patients with an average age of 70 years old. There were 40 MyChart users, 84 telephone users, 26 combination users, and 104 non-users. Compared to non-users, telephone users had significantly lower rates of complications (OR 0.39, 95CI 0.19-0.76), readmissions (OR 0.35, 95CI 0.10-0.99), and composite outcome (OR 0.50, 95CI 0.26-0.94). There were no significant differences between MyChart users and non-users.

CONCLUSIONS

MyChart utilization was not associated with improved postoperative outcomes after cystectomy, while telephone utilization was associated with significantly fewer complications and readmissions. Phone calls may be a more timely and effective way to exchange information perioperatively.