Background: The number of elective outpatient surgeries in Canada has increased markedly in the last 10 years. However, unanticipated cancellations on the day of surgery and adverse postoperative events are frequent. Modern technologies have been shown to be of great help in the medical field in improving patient care. Thus, it is likely that dedicated technologies could also significantly improve surgical outpatients’ pathways. Therefore, the department of anesthesiology at the University of Montreal Medical Center, in collaboration with LeoMed, a telemedicine platform, has developed a telehealth solution to offer more efficient perioperative support and follow-up for patients undergoing ambulatory surgery. Objective: The objective is to evaluate the medicoeconomic benefit of a dedicated perioperative telehealth platform for patients undergoing day surgery. Our hypothesis is that this dedicated telecare solution will allow more efficient patient care, which will reduce all types of medical costs related to day surgery pathways. Methods: This study is a single-center, single-blinded, 2-group randomized controlled trial. One thousand patients aged over 18 years with internet access who are scheduled to undergo ambulatory surgery will be enrolled and randomized either to follow a perioperative path that includes a patient-tailored perioperative digital app via the LeoMed telecare platform for 1 month or to follow the standard of care, which does not offer personalized digital support. The primary outcome will be to evaluate the cost-effectiveness of the telecare platform, assessing direct costs from factors such as unanticipated cancellations on the day of surgery due to preoperative instructions not being followed, calls to the local health information line, calls to the provincial health information line, emergency department consultations, unplanned readmissions, or medical visits for problems related to the surgical procedure within the first 30 days after the intervention. The secondary outcome will be to evaluate cost utility using a questionnaire assessing quality-adjusted life years. A blinded independent research team will analyze outcomes. All data will be analyzed according to the intention-to-treat principle. A sample size of 500 subjects in each group was calculated to detect a 21% reduction in postoperative complications with a power of 90%. This study has been approved by the ethics board of Centre hospitalier de l’Université de Montréal (University of Montreal Health Centre). No employee of LeoMed was involved in the study conception, and none will be involved in either data collection or analysis. Results: Results of this trial will be useful to determine the economic benefit of a telecare platform specifically developed for surgical outpatient pathways. Conclusions: We believe that the deployment of a dedicated perioperative telehealth app will lead to better patient care and fewer postoperative complications, which will lower all types of costs related to surgical outpatient care. Trial Registration: ClinicalTrials.gov NCT04948632; https://ClinicalTrials.gov/ct2/show/NCT04948632
Background: The increasing prevalence of ambulatory surgeries has highlighted the need for effective postoperative follow-up. While telemedicine represents a promising option for perioperative support and postoperative monitoring, evidence of its actual benefits remains limited. Objective: To evaluate the medico-economic impact of a personalized telemedicine platform for postoperative follow-up in day-surgery patients in terms of cost-effectiveness and cost-utility. Methods: Design and Setting: This single-blinded with two-group randomized controlled trial was conducted at the Centre hospitalier de l’Université de Montréal (CHUM) from August 2022 to September 2023. Participants: Adults undergoing elective day surgery were randomized into two groups: the intervention group, which received postoperative follow-up via the LeoMed® telemedicine platform, and the control group, which received standard care. The study adhered to ethical standards and was registered with ClinicalTrials.gov (NCT04948632). Intervention: The intervention group used a personalized telehealth platform offering preoperative education, psychological support, and postoperative monitoring through daily follow-up forms sent to patients’ smartphones. Alerts generated by patient responses were reviewed by CHUM’s telehealth support unit. Main Outcomes and Measures: The primary outcome was unanticipated healthcare utilization, including emergency visits, readmissions, and medical consultations within 30 days post-procedure. Secondary outcomes included gained quality-adjusted life years (QALY), patient satisfaction, healthcare costs, and greenhouse gas emissions. Results: Of 1,411 patients screened, 1,214 were randomized, with 436 in the intervention group and 445 in the control group analyzed. No significant differences in unanticipated healthcare utilization or costs were observed. The intervention group demonstrated a statistically significant QALY gain at postoperative day 14 (0.002, p = 0.013), but the difference was no longer significant at day 30 (0.001, p = 0.143). However, patient satisfaction was significantly higher in the intervention group at both days 14 (p = 0.018) and 30 (p < 0.001). Conclusions: This trial demonstrates the potential of telemedicine platforms to enhance postoperative care in ambulatory surgery settings. While no significant reductions in healthcare utilization were observed, the intervention improved QALYs and patient satisfaction, suggesting potential cost-utility benefits. Larger trials are needed to confirm these findings and explore the impact on long-term recovery and healthcare savings. Clinical Trial: ClinicalTrials.gov Identifier: NCT04948632