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Abstracts and Programme, EUROANAESTHESIA 2008: Evidence-Based Practice and Quality Assurance

A web-based preoperative assessment system for anaesthetic risk management, patient information service and a cost effective process of care


Zuidema, X.; Houweling, P.; Meesters, R. Tromp; van Woerkens, L.; Siccama, I.

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European Journal of Anaesthesiology (EJA): May-June 2008 - Volume 25 - Issue - p 15
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Background and Goal of Study: Preoperative assessment by anaesthesiologists in many cases is inconsistent and time-consuming. Information transmission to patients is often not standardized and frequently incomplete, as is post-operative outcome data, including follow-up and patient satisfaction. Data are therefore hard to interpret. We recently presented a preoperative information system using decision rules, standardized care and prediction models. In this study we added an interactive communication device that takes and provides personalised perioperative patient information in order to further ameliorate logistic planning and reduce health care costs.

Materials and Methods: We used our preoperative information system (Synopsis®) which consists of 49 questions to identify and score conditions that are known to be risk factors. Patients can complete the questionnaire from home, using a standard web browser. The collected answers are assessed by decision logic, resulting in a preoperative assessment that quantifies anaesthetic, cardiac and pulmonary risk. Online communication between patient and anaesthesiologist for scheduling and procedure specific information is delivered by the communication device.

Results and Discussion: Since the introduction of Synopsis® in 2006 over 10.000 patients have been included. There were no significant differences between the estimated physical condition from Synopsis® and those given by the anaesthesiologist (Figure 1).

Figure 1
Figure 1

Figure 2 shows an absolute annual cost reduction of 126.853 euro which reflexes a calculated cost reduction of 15 euro per patient.

Figure 2
Figure 2

Conclusion(s): The Synopsis® questionnaire in combination with a web-based interactive information system is a valid and safe method for assessing patient risk, and can be used to triage patients and select patients who will need a preoperative work up. We showed that using a web-based route, healthcare costs can be largely reduced.

© 2008 European Society of Anaesthesiology