Practice Improvement Project: Developing a Platform for a Remote At-Home Preoperative Evaluation for Elective Noncardiac Procedures.

Objective: To assess the feasibility, safety, and patient satisfaction associated with a remote cardiac evaluation protocol during a preanesthesia medical evaluation (PAME) before elective noncardiac surgical procedures. Patients and Methods: Eligible patients undergoing elective noncardiac procedures from May 1, 2022 to September 30, 2023 were selected from an anesthesia triage list at a single health care center. Patients received electronic devices for remote blood pressure measurement and 12-lead electrocardiogram collection. Patients either had a telemedicine-based PAME (tPAME) visit or an in-person PAME (iPAME) visit afterward. Patients' charts were reviewed 30 days after procedure to identify after procedure complications. Patients were asked to provide feedback about their experiences through a digital after procedure satisfaction survey. Comparisons between the tPAME group and the iPAME group were made with χ Results: Of 129 eligible patients, 48 (37.2%) participated in the study. 29 (60.4%) patients had an iPAME visit, and 19 (39.6%) patients had a tPAME visit. There were no major adverse cardiovascular events after a remote cardiac evaluation in the iPAME and the tPAME groups. One (3.4%) patient in the iPAME group developed a deep vein thrombosis and pulmonary embolism after procedure, and 1 (3.4%) patient in the iPAME group had an emergency room visit within 30 days after their procedure. Patients were very satisfied with their experience in the study. Conclusion: These findings support the concept that a remote cardiac evaluation during a PAME before elective noncardiac procedures is feasible, safe, and associated with high patient satisfaction.