Patrick Sanger

Surgical site infections (SSI) are a common, costly and serious problem following surgery, affecting at least 500,000 people per year. Most infections now occur after hospital discharge, placing the burden of recognizing problems and seeking care on patients who are ill-prepared for that responsibility, resulting in reduced quality of life and preventable readmission. Yet, few efforts have been made to systematically engage patients in early identification of SSIs at home to reduce their impact.

I will describe a novel approach to addressing this problem: a patient-centered mobile health (mHealth) application that enables patients to serially track wound symptoms and photos, and securely communicate with their providers. To this end, I first present a needs assessment among surgical patients and clinicians. I then describe an iterative process of engagement with these stakeholders resulting in design considerations generalizable to post-acute care mHealth (of which wound tracking is a part). Finally, I assess the clinical value of serial wound data and photos.

My work enhances understanding of the challenges facing patients who develop post-discharge SSI, and begins to map the unexplored design space of post-acute care mHealth, especially around areas of patient-clinician conflict. In addition, I propose a new method to aid in design of patient-centered health IT and demonstrate the value of serial wound data and photos beyond existing data sources. In addition to these contributions to research, I am making an applied contribution to the development of mPOWEr, a wound-tracking tool that seeks to improve clinical outcomes and patients’ experience on the way to those outcomes.