Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n2209 (Published 30 September 2021) Cite this as: BMJ 2021;374:n2209
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Dear Editor
There seem to be 2 interventions here. One is the virtual nurse visits that include a photo of the patient's healing incision, the other is the remote collection of vital signs. Which intervention made the difference?
Practically everyone has a mobile phone with a camera, so they can complete a questionnaire, take a call from a nurse, reconcile meds, describe new symptoms, and send a photo. This is a more cost-effective approach than the thousands of dollars/pounds/euros to buy all the tablets and software for remote monitoring. I am surprised there was not a third group who received the virtual visits only - as a patient, such an intervention sounds wonderful to me!
Competing interests: No competing interests
Dear Editor
I enjoyed reading the authors list.
It’s a clue as to the man hours involved.
What is not addressed is the time and cost of the RAM or standard practice arms.
I am a proponent of monitoring in principle, and this article adds some support for RAM.
But it may be that staff hours were extended into one group?
This extra attention could then influence outcomes by placebo and white coat effects?
The ultimate point of travel will no doubt be an App driven service through a wrist watch or similar linked device, at which point RAM may consume many more man hours in cold calls, distractions, and diversion of resources!
The man hours consumed need to be explicit, to give value to this practice?
I see this as critical to enable evaluation in the scientific medical paradigm!
We are someway from the ‘star trek’ hand held diagnostic device , this is a step forward, or is it?
Please address the patient contact time and man hours in each group, as a matter of full disclosure, to validate the claims.
Thanks
John
Competing interests: No competing interests
Re: Post-discharge after surgery Virtual Care with Remote Automated Monitoring-1 (PVC-RAM-1) technology versus standard care: randomised controlled trial
Dear Editor
The supplementary material is repetitive and missing supplementary tables. Please review and have the correct information uploaded to your site.
Competing interests: No competing interests