Mobile Perioperative Health: The Technological Transformation

Archana Bharadwaj, MD, MPH

The explosion of technological advancements has created new opportunities to collect perioperative data and design interventions to improve health. In the panel, “Transformative Tech: Devices and Apps Advancing Perioperative Health Across Ages,” cosponsored by the Early-Stage Anesthesiology Scholars (eSAS) and held on Sunday, March 23 at the 2025 Annual Meeting, presented by IARS and SOCCA, three panelists discussed the ways in which mobile applications and other technologies are being leveraged in the perioperative space. This panel was moderated by Daniel Rubin, MD, Associate Professor of Anesthesia and Critical Care at The University of Chicago.

Sydney Brown, MD, PhD, an assistant professor of Anesthesiology at the University of Michigan, discussed, “Mobile Interventions Applied Across Pediatric Oncology and Pediatric Surgical Populations.” For most children, pain and physical function tend to drive surgical intervention, therefore leading to a need for patient-reported outcomes. In a feasibility study examining the utilization of mobile applications for assessing postoperative symptoms in adolescent orthopedic surgery patients, more than 90% of the participants agreed that weekly surveys were acceptable. In a study of pediatric cancer patients undergoing longitudinal chemotherapy for cancer care, a significant decline in self-reported health prior to an unplanned admission was noted. To assess whether caregivers would adopt mobile health interventions to address perioperative anxiety and wellbeing, a survey was conducted that found that most caregivers thought interventions would be at least somewhat useful. Dr. Brown concluded that mobile health is a new tool that is well liked by patients and caregivers and may be useful for perioperative symptom management and related interventions.

Jennifer Rabbitts, MD, professor of Anesthesiology, Perioperative, and Pain Medicine at Stanford University School of Medicine, discussed “Mobile Health Interventions for Adolescents to Improve Perioperative Pain, Sleep, and Anxiety.” A systematic review of 18 studies with more than 2,000 children found that 28% of children experience chronic postsurgical pain. Risk factors for developing chronic pain after surgery include anxiety, pain catastrophizing, and poor sleep. To address this issue, a mobile health intervention was designed that spanned one week preoperatively to one week postoperatively. It included three preoperative modules covering preparing for surgery, coping with worry before surgery, and getting ready for hospital and recovery. The postsurgical phase included coping at home after surgery, getting back to activities, and long-term recovery. The modules build skills throughout the perioperative period, including relaxation, sleep hygiene, and pain self-management. The children can check in through the app and track their symptoms. If they report increasing pain or worse sleep, the content is tailored accordingly. This application has been tested in 433 teens undergoing spinal fusion surgery, with results pending. Initial feedback from parents and children illustrates increased confidence in navigating the perioperative period and decreased anxiety.

Dr. Rubin concluded the panel with “Wearable Devices and Mobile-Apps to Facilitate Perioperative Physical Function Assessments and Interventions in Older Adults.” Poor physical function increases the risk of disability after surgery; however, functional assessments before surgery are infrequently performed. Analysis of wearable data from the Study of Muscle Mobility and Aging (SOMMA), a prospective cohort study out of the University of Pittsburgh, showed participants with poor functional capacity had a lower step count and lower moderate-intensity physical activity. Wearable data is limited, as it provides a passive form of collection and only explores current behavior not ability. Therefore, an application was built that assessed at-home walking cadence before major abdominal surgery. The in-clinic walk cadence correlated well with the data measured by the application illustrating the utility of the application to measure activity. To improve older adult health before surgery, a mobile application that utilizes rhythmic auditory cueing has been developed to increase moderate-intensity walking. Enrollment for a pilot trial has begun and preliminary data have shown an improvement in walking cadence.