​Data collection following day surgery promotes health and safety development

The IT solution RAPP establishes a direct line between patient and caregiver following day surgery operations. It creates greater security and opportunities for clinical development. RAPP was granted support in the 2016 BIO-X call ‘New diagnostic solutions for disease monitoring’.

“Actually, it’s not so difficult technically; we simply collect data on how the patient is feeling after a day surgery operation with an app. Rather, the big deal is that the caregiver can utilise this data to improve care”, says Ulrica Nilsson, professor at the School of Health Sciences, Örebro University, and inventor of the IT solution RAPP.

As an experienced anaesthesia nurse, Ulrica has for many years been concerned about the lack of follow-up. Day surgery patients often have very little contact with health services during their recovery, and this creates two problems. Firstly, patients are left alone with their worries and concerns; whether the pain they feel is normal or if the wound is healing properly, for example. Secondly, clinical data is not recorded in journals where it could be used for quality assurance and the further development of healthcare.

With RAPP (Recovery Assessment by Phone Points), Ulrica and her project colleagues tackle this complex problem with a simple concept. Following surgery, patients get help to install an app on their smartphone. They then answer 24 fixed questions each day, entering, for example, how much pain they feel, how the wound is healing or how they are sleeping. The questions are based on a validated questionnaire – a Swedish version of the internationally renowned Quality of Recovery – with the addition of one final question; “Do you want a nurse to contact you”? If the patient answers “yes”, a nurse calls within twenty-four hours.

It turns out that about 25 percent of patients do want contact with the health services and being able to achieve this quickly helps them feel secure. Often their concern is about something they can handle themselves; how to change a bandage, for example.

RAPP is being developed by Örebro University with technical support from the IT company Nethouse and regional development aid from Region Örebro. Interest from healthcare has been great and there is a real sense of urgency from the developers to get moving with a finished product. Within the framework of the BIO-X project, the developers are now getting to grips with the ‘fine print’. This includes examining the legal aspects surrounding data management and security. (In this context, it should be noted that until further notice, data in the RAPP system remain outside of national quality registers.) Work on laying the foundations for a CE-marking is also under way, since apps like RAPP are subject to medical technology legislation.

“Our cooperation with BIO-X has been very positive. Their coaches have really shared their know-how with us. But equally important has been learning from the experiences of other projects”, says Peter Blomberg, operational manager at RAPP AB.

It’s actually not the first time that the RAPP team has been involved in competing for BIO-X funding.

“The first time we fell at the final hurdle, but we picked ourselves up, brushed it aside and continued”, says Ulrica Nilsson. “Today we think it was fortunate that we didn’t receive funding because at the time we were not really ready for it.

Day surgery operations

Each year, about two million day-surgery operations are performed in Sweden, i.e. operations where the patient goes home the same day. Typical interventions include inguinal hernia, varicose veins and gynaecological or orthopaedic surgery. Day surgery is not only easier for patients, it also saves healthcare resources and at the same time reduces the risk of complications, e.g. healthcare-related infections.