Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial
BackgroundA substantial proportion of patients require acute hospital care after hospital discharge post surgery, and many regions and countries have surgical backlogs. ObjectiveThe Post Discharge After Surgery Virtual Care with Remote Automated Monitoring Technol...
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JMIR Publications
2025-06-01
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| author | Sandra Ofori Michael H McGillion Flavia K Borges Carley Ouellette Ameen Patel David Conen Maura Marcucci Michael Ke Wang Lily Jaeyoung Park Conor Bell Jennifer Lounsbury Kanae Nagatani Vikas Tandon Trevor J Wilkieson Ahraaz Wyne Valerie Harvey Stephanie Harrison Rahima Nenshi Jessica Bogach John Harlock Margherita Cadeddu Shawn Forbes Shariq Haider Reza D Mirza Sunita Narang Clare J Reade Daniel M Tushinski Amit Raut Samir Raza Ted Scott Anthony Adili Jeremy Petch PJ Devereaux |
| author_facet | Sandra Ofori Michael H McGillion Flavia K Borges Carley Ouellette Ameen Patel David Conen Maura Marcucci Michael Ke Wang Lily Jaeyoung Park Conor Bell Jennifer Lounsbury Kanae Nagatani Vikas Tandon Trevor J Wilkieson Ahraaz Wyne Valerie Harvey Stephanie Harrison Rahima Nenshi Jessica Bogach John Harlock Margherita Cadeddu Shawn Forbes Shariq Haider Reza D Mirza Sunita Narang Clare J Reade Daniel M Tushinski Amit Raut Samir Raza Ted Scott Anthony Adili Jeremy Petch PJ Devereaux |
| author_sort | Sandra Ofori |
| collection | DOAJ |
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BackgroundA substantial proportion of patients require acute hospital care after hospital discharge post surgery, and many regions and countries have surgical backlogs.
ObjectiveThe Post Discharge After Surgery Virtual Care with Remote Automated Monitoring Technology-3 (PCV-RAM-3) trial tests the hypothesis that informing surgeons and patients of virtual care with remote automated monitoring (VC-RAM) assignment will promote earlier discharge, thereby reducing the index length of hospital stay, and that postdischarge VC-RAM will reduce acute hospital care.
MethodsThe PVC-RAM-3 trial is a randomized controlled trial that compares VC-RAM to standard postdischarge care among 2500 adults undergoing elective noncardiac surgery in 3 Canadian hospitals. Following the randomization of patients prior to surgery, surgeons and patients are immediately notified whether the patient has been allocated to the VC-RAM or control group. Outcome adjudicators remain blinded to each participant’s group assignment. Patients in the intervention arm learn to use a Health Canada–approved cellular modem–enabled tablet computer and Bluetooth-enabled remote automated monitoring technology from Cloud DX to take daily wound photos for 7 days and measure daily vital signs (ie, blood pressure, heart rate, oxygen saturation, temperature, and weight) three times daily on days 1-7 and twice daily on days 8-14 post discharge, along with completing a brief recovery survey. Nurses review these data and conduct scheduled virtual visits (days 1, 3, 7, and 14). Nurses will escalate care to a preassigned and available perioperative care physician if predetermined vital sign thresholds are exceeded, concerning symptoms arise, or a medication error is detected. These physicians manage the issues and add or modify treatments as needed. The standard care group will receive postdischarge care as per the standard of care at the hospital where they undergo surgery. The coprimary outcomes are acute hospital care and the index hospital length of stay within the first 30 days after randomization.
ResultsStudy recruitment and follow-up are completed, and analysis of the study results is underway.
ConclusionsThis trial will offer insights into the role of VC-RAM in reducing acute hospital care and index length of hospital stay among adults undergoing elective surgery.
Trial RegistrationClinicalTrials.gov NCT05171569; https://clinicaltrials.gov/ct2/show/NCT05171569
International Registered Report Identifier (IRRID)DERR1-10.2196/72672 |
| format | Article |
| id | doaj-art-12a3a153c2634ab58cdeece2ec3dc571 |
| institution | DOAJ |
| issn | 1929-0748 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Research Protocols |
| spelling | doaj-art-12a3a153c2634ab58cdeece2ec3dc5712025-08-20T03:05:17ZengJMIR PublicationsJMIR Research Protocols1929-07482025-06-0114e7267210.2196/72672Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) TrialSandra Oforihttps://orcid.org/0000-0002-1691-0979Michael H McGillionhttps://orcid.org/0000-0002-1343-7012Flavia K Borgeshttps://orcid.org/0000-0001-5377-7612Carley Ouellettehttps://orcid.org/0000-0003-3242-6164Ameen Patelhttps://orcid.org/0000-0002-9338-2815David Conenhttps://orcid.org/0000-0002-2459-5251Maura Marcuccihttps://orcid.org/0000-0002-8468-7991Michael Ke Wanghttps://orcid.org/0000-0002-4949-3235Lily Jaeyoung Parkhttps://orcid.org/0000-0002-0372-3525Conor Bellhttps://orcid.org/0000-0002-5595-8246Jennifer Lounsburyhttps://orcid.org/0009-0007-5537-7832Kanae NagataniVikas Tandonhttps://orcid.org/0009-0007-0257-3936Trevor J Wilkiesonhttps://orcid.org/0009-0009-9004-8238Ahraaz Wynehttps://orcid.org/0009-0007-6114-9780Valerie Harveyhttps://orcid.org/0000-0002-3075-4036Stephanie Harrisonhttps://orcid.org/0009-0005-4656-579XRahima Nenshihttps://orcid.org/0009-0001-2124-2004Jessica Bogachhttps://orcid.org/0000-0001-5536-1530John Harlockhttps://orcid.org/0000-0002-6631-7399Margherita Cadedduhttps://orcid.org/0009-0008-6261-7395Shawn Forbeshttps://orcid.org/0000-0001-5653-2119Shariq Haiderhttps://orcid.org/0000-0002-3776-5926Reza D Mirzahttps://orcid.org/0000-0002-0576-4208Sunita Naranghttps://orcid.org/0009-0004-1078-7457Clare J Readehttps://orcid.org/0000-0001-6018-6503Daniel M Tushinskihttps://orcid.org/0000-0002-2117-4654Amit Rauthttps://orcid.org/0009-0005-8001-8124Samir Razahttps://orcid.org/0009-0005-3387-9706Ted Scotthttps://orcid.org/0000-0002-6190-050XAnthony Adilihttps://orcid.org/0000-0003-4692-819XJeremy Petchhttps://orcid.org/0000-0003-1614-1046PJ Devereauxhttps://orcid.org/0000-0003-2935-637X BackgroundA substantial proportion of patients require acute hospital care after hospital discharge post surgery, and many regions and countries have surgical backlogs. ObjectiveThe Post Discharge After Surgery Virtual Care with Remote Automated Monitoring Technology-3 (PCV-RAM-3) trial tests the hypothesis that informing surgeons and patients of virtual care with remote automated monitoring (VC-RAM) assignment will promote earlier discharge, thereby reducing the index length of hospital stay, and that postdischarge VC-RAM will reduce acute hospital care. MethodsThe PVC-RAM-3 trial is a randomized controlled trial that compares VC-RAM to standard postdischarge care among 2500 adults undergoing elective noncardiac surgery in 3 Canadian hospitals. Following the randomization of patients prior to surgery, surgeons and patients are immediately notified whether the patient has been allocated to the VC-RAM or control group. Outcome adjudicators remain blinded to each participant’s group assignment. Patients in the intervention arm learn to use a Health Canada–approved cellular modem–enabled tablet computer and Bluetooth-enabled remote automated monitoring technology from Cloud DX to take daily wound photos for 7 days and measure daily vital signs (ie, blood pressure, heart rate, oxygen saturation, temperature, and weight) three times daily on days 1-7 and twice daily on days 8-14 post discharge, along with completing a brief recovery survey. Nurses review these data and conduct scheduled virtual visits (days 1, 3, 7, and 14). Nurses will escalate care to a preassigned and available perioperative care physician if predetermined vital sign thresholds are exceeded, concerning symptoms arise, or a medication error is detected. These physicians manage the issues and add or modify treatments as needed. The standard care group will receive postdischarge care as per the standard of care at the hospital where they undergo surgery. The coprimary outcomes are acute hospital care and the index hospital length of stay within the first 30 days after randomization. ResultsStudy recruitment and follow-up are completed, and analysis of the study results is underway. ConclusionsThis trial will offer insights into the role of VC-RAM in reducing acute hospital care and index length of hospital stay among adults undergoing elective surgery. Trial RegistrationClinicalTrials.gov NCT05171569; https://clinicaltrials.gov/ct2/show/NCT05171569 International Registered Report Identifier (IRRID)DERR1-10.2196/72672https://www.researchprotocols.org/2025/1/e72672 |
| spellingShingle | Sandra Ofori Michael H McGillion Flavia K Borges Carley Ouellette Ameen Patel David Conen Maura Marcucci Michael Ke Wang Lily Jaeyoung Park Conor Bell Jennifer Lounsbury Kanae Nagatani Vikas Tandon Trevor J Wilkieson Ahraaz Wyne Valerie Harvey Stephanie Harrison Rahima Nenshi Jessica Bogach John Harlock Margherita Cadeddu Shawn Forbes Shariq Haider Reza D Mirza Sunita Narang Clare J Reade Daniel M Tushinski Amit Raut Samir Raza Ted Scott Anthony Adili Jeremy Petch PJ Devereaux Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial JMIR Research Protocols |
| title | Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial |
| title_full | Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial |
| title_fullStr | Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial |
| title_full_unstemmed | Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial |
| title_short | Impact of Virtual Care With Remote Automated Monitoring on the Rate of Acute Hospital Care Post Discharge and Index Length of Hospital Stay: Protocol for the Post Discharge After Surgery Virtual Care With Remote Automated Monitoring Technology 3 (PVC-RAM-3) Trial |
| title_sort | impact of virtual care with remote automated monitoring on the rate of acute hospital care post discharge and index length of hospital stay protocol for the post discharge after surgery virtual care with remote automated monitoring technology 3 pvc ram 3 trial |
| url | https://www.researchprotocols.org/2025/1/e72672 |
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