Discussion
PGHD, gastrointestinal oncologic operations
COMPLICATIONS
This study is one of the first to incorporate PGHD in the form of vital signs, mobility, and ePROs, coupled with nursing intervention triggered by set thresholds [However, there are many questions to be answered regarding the applicability and utility of such an approach in the perioperative care of such patients. The patients who consented to participate in this study had a high level of baseline digital literacy, with 100% of participants indicating ownership of or access to a smartphone and the majority indicating that they had access to smartphone apps, internet, and text messaging. It remains unclear whether patients who did not have access to such technology at baseline would be comfortable consenting to a remote telemonitoring program such as the one offered here, as disparities in digital literacy have been associated with inability to participate in internet based health interventions [This study is limited by several factors. Firstly, it was conducted at a single institution, which may limit its generalizability to the general population undergoing complex gastrointestinal oncologic operations, particularly given the young age and the high level of education achieved by this study’s participants. Furthermore, only those patients able to read and write in English were able to be included due to limitations of the technology used. Future studies will need to investigate the use of remote telemonitoring platforms for non-English speakers and those with limited literacy, as this may represent a source of disparity [In conclusion, remote telemonitoring after discharge for patients undergoing complex gastrointestinal oncologic surgery appears feasible and acceptable, and higher levels of adherence are associated with the receipt of nursing triage outreach. Further research will be necessary to understand implications for the duration of telemonitoring, the impact on resource utilization and the potential to mitigate severity of complications by earlier identification.