In this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up.

As part of a quality initiative, we developed an automated post-operative follow-up system for patients following discharge after cardiac surgery at Boston Children’s Hospital.

Discharge Communication (DisCo) is a web-based system developed at Boston Children’s Hospital. An automated text and e-mail with a link to a health status survey are sent at 30 days and 1 year post-discharge in English/Spanish. If there is no response, surveys are completed via phone calls to the patient/patient’s physician or chart review. Responses are stored in the DisCo database and the patient’s medical record. Patients who underwent cardiac surgery and survived to hospital discharge from October, 2016 received the surveys.

Overall, 3345 30-day and 2563 1-year surveys were sent between October, 2016 and June, 2020. Of 3345 30-day surveys, there were 3191 responses (95%). Of 2563 1-year surveys, there were 1807 responses (71%). Most patients/families responded directly to the link at 30 days (65% for paediatrics/75% for adults) and at 1 year (72% for paediatrics/78% for adults). Multi-variable logistic regression revealed that higher complexity of cardiac lesion, presence of major non-cardiac anomalies and presence of major residua were associated with readmission and catheter/surgical reinterventions. Non-cardiac anomalies were associated with increased need for services for learning, development or behaviour.

DisCo provides a successful web-based health status assessment of patients following congenital cardiac surgery. It helps to identify high-risk patients who need closer follow-up.

在这个公众监督的时代，不断需要创新的患者随访方法。

作为质量计划的一部分，我们为波士顿儿童医院心脏手术后出院的患者开发了一个自动化的术后随访系统。

出院通信 (DisCo) 是波士顿儿童医院开发的基于网络的系统。在出院后 30 天和 1 年以英语/西班牙语发送带有健康状况调查链接的自动文本和电子邮件。如果没有回应，则通过给患者/患者的医生打电话或查看图表来完成调查。响应存储在 DisCo 数据库和患者的医疗记录中。从 2016 年 10 月起接受心脏手术并存活至出院的患者接受了调查。

总体而言，2016 年 10 月至 2020 年 6 月期间发送了 3345 份 30 天和 2563 份 1 年调查。在 3345 份 30 天调查中，有 3191 份回复（95%）。在 2563 次为期 1 年的调查中，有 1807 次回复（71%）。大多数患者/家庭在 30 天（儿科 65%/成人 75%）和 1 年（儿科 72%/成人 78%）时直接响应链接。多变量逻辑回归显示，心脏病变的复杂性、主要非心脏异常的存在和主要残留物的存在与再入院和导管/手术再干预有关。非心脏异常与对学习、发展或行为服务的需求增加有关。

DisCo 为先天性心脏手术后的患者提供基于网络的成功健康状况评估。它有助于识别需要更密切随访的高危患者。