Activity monitors measure step counts for surgery patients

Patients wearing Fitbit devices were able to measure step count after major surgery, improving clinical assessment of daily ambulation and helping to predict their length of hospital stay.

A prospective cohort study of 100 patients at Cedars-Sinai Medical Center, published in JAMA Network Open, found that for every 100 steps taken by post-operative participants they decreased their length of stay by 4 percent.

“We measure everything about our patients—whether it’s heart rate, blood pressure (and such)—but nowhere do we measure steps, even though we know steps are so important for a patient’s wellbeing. Now we have the ability to do so,” says Brennan Spiegel, MD, senior author of the study and director of Cedars-Sinai’s Center for Outcomes Research and Education.

The use of activity monitors in the postoperative clinical setting are effective for measuring patient step counts and tracking their recovery, according to Timothy Daskivich, MD, who led the study and is director of health services research at the Cedars-Sinai Department of Surgery.

“Activity monitors provide an inexpensive platform for more precise assessment, ordering and monitoring of step count toward evidence-based daily goals and may indeed become a sixth vital sign for surgical teams,” conclude the study’s authors.

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Going forward, Daskivich and his research team are pursuing a randomized controlled trial at Cedars-Sinai to investigate whether use of these devices can increase step counts and reduce length of stay.

“We’re operationalizing this pop culture tech device for a real clinical purpose in the hospital, and using rigorous science to guide the process,” adds Daskivich. “We think it’s exciting, and patients are responding to it.”

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“The concept of using activity monitors to measure postoperative ambulation is scalable and can be digitally integrated into the electronic medical record (EMR) to allow for real-time feedback to patients and surgical teams,” add the authors. “Although pedometers could be used to monitor step count, the process of integrating serial pedometer measurement into clinical workflows would be prohibitively cumbersome. In contrast, digital interfaces between activity monitors, the EMR and software packages to provide visualizations for feedback have the potential to make this process feasible.”

The study notes that a successful digital interface has previously been demonstrated between activity monitors and Cedars-Sinai’s EMR from Epic Systems, enabling step count data to “passively populate a data field” within the system.

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