A study conducted at Sinai Hospital of Baltimore found that robotic telerounding may significantly reduce the length of stay of patients undergoing laparoscopic gastric bypass surgery if used to supplement standard postoperative visits, or “rounds,” made by surgeons.
“One of the crucial keys of delivering the high-quality care patients have come to expect at Sinai is communication. The technology used in the robotic telerounding offers both physicians and patients increased access to each other beyond traditional in-room visits,” said Alex Gandsas, M.D., lead investigator and head of the Division of Bariatric and Minimally Invasive Surgery at Sinai Hospital.
The 5-foot, 5-inch robot, displaying the doctor’s face on a 15-inch screen, is guided by a joystick from a computerized Control Station in patient rooms, emulating an on-site experience. With on-board, two-way cameras, microphones, and wireless technology, physicians are able to review charts, current lab work and X-ray results without physically being in the hospital.
"We know from previous studies that patient satisfaction was high with robotic telerounding, but we wanted to learn if it also could deliver cost savings, and there's no question it does," said Gandsas.
The study evaluated 376 patients who underwent a laparoscopic gastric bypass for morbid obesity. Of those patients, 284 were assessed by standard bedside physician rounds during the postoperative period. A second group of 92 patients were assessed by traditional surgeon bedside visits, supplemented by robotic telerounding. Patients who suffered from postoperative complications during the same admission were omitted from the study.
Following robotic rounds, 77 percent of patients were discharged on the first postoperative day, whereas none of the patients assessed exclusively by bedside rounds were discharged on day one. The mean length of stay was reduced from 2.33 days for the group assessed exclusively by bedside rounds to 1.26 days for the group assessed by robotic telerounding. Early discharge in the robotic telerounding group created capacity for an additional 71 patient/days, representing a total financial gain of $219,578 for 54 occupied beds. In addition, a total room and board savings of $14,378 was realized due to early discharge.
The report, “Robotic Telepresence: Profit Analysis in Reducing Length of Stay after Laparoscopic Gastric Bypass," will appear in the July issue of the Journal of the American College of Surgeons. In addition to Gandsas, Mitesh Parekh, M.D., Michele M. Bleech, B.A., and Dalton A. Tong, M.B.A., C.P.A., F.A.C.H.E., F.H.F.M.A., co-authored the article.
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