SUFU 2019: A New Paradigm for Outpatient Diagnosis and Treatment of Lower Urinary Tract Symptoms Utilizing a Mobile App/Software Platform and Remote Patient Visits

Miami, FL (UroToday.com) Dr. Blaivas and associates in the project aimed to develop novel diagnostic and treatment paradigms for patients with lower urinary tract symptoms (LUTS) utilizing a software program comprised of a mobile app, validated patient-reported outcome (PRO) questionnaires, bladder diaries, and remote patient monitoring. The goals are to triage patients, optimize quality, accuracy, and efficiency of in-office visits, substitute remote visits for in-office visits, enhance the quality of care, reduce costs and foster patient education, engagement, and self-help.

Participants recruited and offered remote, instead of in-office visits, when appropriate. Those who agreed were invited to download a mobile app containing the lower urinary tract symptom score (LUTSS) and a 24-hour bladder diary. Participants with low (<14) or intermediate (14 - 42) LUTSS were offered remote visits; those with high scores (43 – 56), reflecting severe symptoms, were offered in-office visits. Data obtained included: age, sex, number screened, excluded, included, lost to follow-up, remote visits, in-office visits, app downloads, the time lapse between initial referral, invite and remote or in-office visit.

They found that the overall, remote visits were achieved in 17% of the entire cohort and 68% of those who completed the app. 34/57 (60%) completed the satisfaction questionnaire. Among patients surveyed,80% found the app to be an effective way of sharing information with their physician, and 74% found it to be easy and effective to use.

They concluded that this a new paradigm for outpatient diagnosis and treatment of LUTS was developed using a software program comprised of a mobile app, validated PRO questionnaires, bladder diaries, and remote patient monitoring. Patients were triaged according to symptom severity, and 68% of those who completed the app elected to have their initial evaluation performed remotely (17% of all new urology consults). Patient and physician satisfaction was high.

Further studies, extending and applying the paradigm to a larger and more diverse group of patients, are necessary to determine the extent of its healthcare quality and economic benefit.

Presented by: Jerry G. Blaivas, MD, Senior Faculty, Department of Urology, The Mount Sinai Hospital, Mount Sinai Beth Israel, SUNY Downstate College of Medicine, the Institute for Bladder and Prostate Research
Co-Authors: Michael W. Poon, MD4, Eric S.W. Li, BA2,3, Roni Manyevitch, BA3, Devon N. Thomas, BA3
Author Affiliation:
1. Department of Urology at the Icahn School of Medicine at Mount Sinai
2. SUNY Downstate College of Medicine
3. Institute for Bladder and Prostate Research
4. Kaiser Permanente

Written by: Bilal Farhan, MD, Clinical Instructor, Female Urology and Voiding Dysfunction, Department of Urology, University of California, Irvine @Bilalfarhan79  at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction Winter Meeting, SUFU 2019, February 26 - March 2, 2019, Miami, Florida