Better Colonoscopy was developed to have a reliable and consistent system to deliver best practices to patients undergoing colonoscopy. After the implementation there has been an improvement in clinical outcomes of patients undergoing colonoscopy. There is better utilization of resources, reduced incidence of repeat scopes due to poor bowel preparation and incomplete first colonoscopies, and reduced scope cancellations due to no show or medical conditions.
However, a significant percentage of scheduled colonoscopy cases were still not done, due to cancelled colonoscopies or no show cases ie. patient just did not turn up for procedure. The reasons for cancellation included patients’ non-compliance to instructions for preparations, such as not stopping or continuing with certain medications, inadequate fasting and poor bowel preparation.
A solution is needed to improve patient’s compliance to colonoscopy preparation, and in turn reduce cancellation and no show rates. Current clinical trials and recent work show that a simple educational mobile app that conveys information significantly improves the quality of a scope as compared to conventional paper explanation. The proposed advanced mobile application incorporates all the best practice workflow elements into an automated and adaptive workflow for colonoscopy preparations, customized to a patient’s personal medical condition and medications.
Technology Features, Specifications and Advantages
The app implements the workflow elements in an automated instructional manner with rulesets programmed within the system, and with calibrated step-by-step reminders for the patients at all stages of their bowel preparation. Based on a patient’s medical condition and current medications as parameters, the colonoscopy workflow could be automated with supervised learning methods and mapped to a knowledge based decision tree.
The app can be developed
- not only for patients going for colonoscopy, but any endoscopic or surgical procedures,
- for continued use for follow up procedures in the continual monitoring and treatment of the condition,
- and can be adopted by any general hospitals or even private hospitals and clinics.
The app can also target the general population for colonoscopy education.
The majority of current colonoscopy apps are static, client-side only and standalone, serving only as a source of information and providing multimedia educational material. Information about how the procedure was conducted, preparations to be made before that and information on potential risks, was given. Other slightly more advanced apps incorporate static scheduled alarms with reminders for omission of medication and commencement of bowel preparation.
The proposed app is designed to provide personalized feedback to the patient, and a communication aspect as patients are reminded of their appointments and they are able to communicate via the system with the hospital.