Introduction

To create a user-friendly, personalized decision support tool that can display the likelihood of readmission after radical cystectomy, as well as recommendations for optimal follow-up based on published data.

Methods

We developed the "REACT: Readmission Elimination App for Cystectomy Treatment" using Apple's Xcode. This tool uses delay-time analysis models to determine the optimal timing of office visits and phone calls in order to maximize the probability of detecting radical cystectomy patients susceptible to readmission. We calibrated and validated the tool using radical cystectomy patient data from the 2009-2010 Healthcare Cost and Utilization Project State Inpatient Databases, and our institution's bladder cancer database from 2007 to 2011, as published in J Urol. 2016 May;195(5):1362-7.

Results

Our decision support tool generates a forecasted probability of readmission as well as suggested follow-up frequencies. Sample screenshots from the tool are presented in the Figure. After inputting the date of hospital discharge and other patient characteristics, the app tracks the status of the patient, suggests an optimal follow-up strategy, provides patients with the ability to contact their provider by phone, and tracks future appointments.

Conclusions

We integrated a delay-time analysis methodology into a software tool that can run on personal computers, iPads and iPhones to improve follow-up of patients after radical cystectomy. This software generates real-time predictions of the likelihood of readmission and indicates when future follow-up should be performed, so as to identify clinical deterioration in a timely manner. Through further customization and pilot testing, this decision support tool will enable personalized follow-up to help prevent hospital readmission after radical cystectomy.

Funding

none