Postoperative mHealth application: escape from the twilight zone


During the postoperative recovery process, patients may ignore or mistreat symptoms, thus causing complications. As research shows the impact of surgical site infections in the 1990s (by Kirkland KB et al.), Patients with surgical site infections have a 15-fold higher risk of readmission within 30 days. subsequent to discharge. In this case, the patient’s stay in the hospital increases by an average of 6.5 days and the cost of treatment, by more than $ 3,000.

Unfortunately, when patients are discharged, they enter the twilight zone where caregivers are unable to track the health status of individuals between nursing visits and thus ensure successful convalescence. Or … can they?

We proposed a postoperative mHealth application concept integrated with EHR and designed to continuously monitor patients ’recovery progress. It helps patients avoid the twilight zone and stay connected with their caregivers throughout the postoperative period.


The central element of our concept is a HIPAA compatible Postoperative care management system (PCMS) connected to both the EHR and the mobile application (as a backend). The main functions of the PCMS include:

  • Enhance the flow of incoming and outgoing data to and from the mobile application
  • Notification to surgeons about significant patient events, such as fever, dehiscence, and more
  • Exchange of health data information with EHR

The PCMS analyzes patient updates, uploads data to the EHR, and, if necessary, informs surgeons about important changes in the patient’s condition. In addition, the postoperative care management system sends personalized messages to patients and processes data on their current health status, completing the loop.

Architecture of the postoperative care management system

Patient surgeon: milestones in the recovery plan

The PCMS provides patients with personalized EHR information essential for mild convalescence, such as:

  • Drug intake schedule (according to recovery plan)
  • Instructions (on the care of wounds and surgical drains, self-control, exercise, etc.)
  • Nutrition and hydration recommendations (increase protein intake, reduce sugar and salt, take probiotics, etc.)
  • Reminders to change dressings, take an incision photo, send daily health updates, and more.

Patient to surgeon: updates on the convalescence process

To enable surgeons, nurses, and other care team specialists to respond in a timely manner to changes in their health status, the person must provide caregivers with the following information:

  • Subjective (fever, pain, dizziness, nausea, etc.)
  • Objective (temperature, pus, bruises, swelling, seroma, dehiscence, etc.)
  • Medication intake
  • Incision photographs

The patient only records their vitals and sensations in the corresponding fields of the application and taps “Send”.

Possible scenario of use

A surgeon creates a postoperative recovery plan in the EHR or PCMS depending on the type of surgery of the particular patient (cardiac, gastrointestinal, orthopedic, general, breast surgery, etc.), allergies, lifestyle, habits dietary, physical activity level and more.

The patient receives their individual recovery plan through the mobile app and follows the recommendations and instructions (as described above). They also enter and send the caregiver information such as temperature, general well-being, incision photos taken during the surgical wound care routine, discomfort, and more.

Based on the data provided and processed, the postoperative care management system tracks the patient’s current condition and notifies the surgeon or patient (through the postoperative application), if necessary.

For example, PCMS matches the sets of subjective and objective symptoms provided by the patient and determines the high probability of developing an SSI (surgical site infection). In this case, the app alerts a surgeon about possible complications (e.g., an organ or SSI space) and suggests scheduling an appointment to discuss changes in medication, surgical wound care / drainage gaps, and other items. which can impede the recovery process. All of these interactions are driven by PCMS-based notifications.

Benefits of escaping the twilight zone

Patients and caregivers can benefit equally from the advances software development approach, where post-surgery mobile applications are closely linked to patients ’daily incision management and recovery processes. A postoperative application connected to EHR can guarantee the following bonuses:

  • Improve health outcomes, reducing the risk of complications (up to bleeding, acute kidney damage, intestinal obstruction, malignancy, etc.)
  • Reduction of readmission through uninterrupted and constant communication with patients
  • Nursing visits and patient appointments are reduced as patients learn to control their recovery process at home.

If you would like to learn more about the postoperative application as well as the PCMS concept and its integration with an EHR, feel free to contact us. We will be happy to discuss the details and offer you one free consultation ia PoC.

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