Elisabeth-Tweesteden Hospital

Preparing patients digitally.

Preparing more effectively for surgery or medical procedures with E-POS

Preparing patients digitally for surgery or medical procedures. That is how we handle it in our hospital using E-POS. We initially launched this as a pilot project last year. It has now become standard procedure within the Department of Anesthesiology. A year later and after more than 11,000 digitally screened patients, Anesthesiologist Anne Marieken Wolter and Head of Operating Room Operations Tessa Holzhaus-Fuhring are happy to share their experiences with E-POS.

E-POS

How healthy is a patient? That is a crucial question prior to any medical examination or surgery. Previously, patients had to visit the hospital for their health assessment during the so-called preoperative screening. With E-POS, this is handled through a digital questionnaire that patients complete at home. The E-POS system filters the responses and evaluates the surgical risk level. Based on this assessment, we determine whether the patient needs to visit the hospital prior to the procedure, whether we should contact them by phone, or if the information provided in the questionnaire is sufficient.

Digital preparation for surgery or examinations: how high is the risk? And is there still room for a personal touch?

'Patients always have a moment of contact with the outpatient clinic staff. And anyone can schedule an appointment according to their preference, even if the questionnaire has already provided us with sufficient information. So the personal touch is definitely still there, although we are leaning more towards digital solutions because they offer significant advantages. Regarding the risk: the anesthesiologist always reviews the questionnaires personally to verify whether E-POS made the correct assessment and to determine the required medication and/or anesthesia. Therefore, we can always override E-POS,' says Anne Marieken.

One year of E-POS: what did it yield?

'We notice that we can better differentiate between healthy and less healthy patients and thus provide more targeted care,' says Anne Marieken. 'Here is why: previously, all patients came to the hospital prior to surgery or an examination, and we had no prior information about them. We allocate roughly 20 minutes per screening. However, a relatively healthy patient coming in for knee surgery was often finished within just a few minutes. For the patient, this meant an unnecessary hospital visit, whereas we could have utilized that spare time much better for a more vulnerable patient undergoing something like bowel surgery.' Tessa adds: 'E-POS enables us to deploy screenings much more effectively, both for patients and for ourselves. We can help more patients in less time and facilitate customized care.'

How does that translate into figures?

Tessa: 'Over the past year, 80.9% of preoperative screenings were conducted via E-POS. More than 11,000 patients went through the screening process. E-POS was also an exceptional tool for assisting patients remotely during the COVID-19 pandemic. Our hospital naturally receives vulnerable patients as well, and being able to support them remotely through initiatives like this is fantastic. On the other hand, the pandemic situation may have somewhat skewed the figures. Due to COVID-19 measures, outpatient capacity was restricted, and we saw fewer people in person than we would have preferred. Therefore, we plan to conduct a patient satisfaction survey once the situation has completely normalized, ensuring the results are fully representative.'

So E-POS provides the hospital with valuable information. What about the information provided to the patient?

Anne Marieken: 'E-POS offers patients clear videos and animations explaining the examination or surgery. As a result, we notice that patients are well-informed about what to expect and ask us much more targeted questions. Previously, to put it somewhat bluntly, I used to just "check off items on a list"; now there is much more interaction. This makes consultations better and more personal.'

What are your expectations for E-POS in the future?

"The personal aspect will never completely disappear," Tessa anticipates. "However, E-POS offers many advantages. For instance, allowing you and your elderly mother to sit at home with a cup of coffee and jointly fill out information that would normally require a hospital visit. Combined with other eHealth developments, we might coordinate matters remotely with home care, general practitioners, and laboratories in the future. Although I suppose there is eventually a limit to what is possible and necessary," says Tessa. Anne Marieken: "We aim to optimize the flow of information to and from the patient, and direct healthcare resources toward those who truly need them. Take, for instance, the 80-year-old patient who may only have one chance during a complex surgery. E-POS allows us to optimize that opportunity. That motivates me to keep getting the most out of it, and to continuously improve the quality of care specifically for that group."