Integrating post-hospital care by digital counseling tools: A non-randomized proof-of-concept study

Abstract

Abstract Background The duration of stays in hospitals have decreased by almost 50% to an average of 7.2 days in 2021 compared to 1992 whilst reliance on internet-based health information has increased. This trend raises concerns about potential misinterpretations and the need for enhanced post-hospital support. Methods This proof-of-concept study established a chat-based recovery counseling service providing nursing expertise and digital counseling options to patients within 7 days after discharge from hospital. Therefore, real nursing professionals where available to respond to patient queries and questions. A chatbot assisted the counselor by suggesting potential responses based on the patient's questions. This chatbot was trained using the expertise of nursing professionals. The study aimed to assess patients' acceptance, nursing professionals' commitment, and patients' willingness to contribute chat interactions and chat content for further research and tool developments. Surveys and interviews were conducted with recovery counselors to explore their attitudes towards digitalization, self-assessed digital competencies, and potential changes to the service structure. Results Within one year, 247 patients across five stations (surgery, oncology, and orthopedics) were introduced to the digital recovery counseling service. Several patients declined to participate in the study, with the main reason for refusal voluntarily given by patients being the lack of a PC in the household (68.86%). Patients in the 51–70 age group showed the highest positive responses. Out of the consenting patients, all but one agreed to donate their chat history, and 21 of the participants registered on the platform. Neurosurgery patients exhibited the highest interest, while oncology patients had limited interest due to pre-existing information. Recovery counselors reported varying degrees of improved digital competencies. The chatbot presented challenges for uniform training across specialties due to its limited dataset, emphasizing the need for a broader question set for comprehensive training. Conclusions The study shows patients acceptance for digital counselling via chat, emphasizing also nursing staff's readiness for digital expansion. Integrating digital training is vital to overcome initial doubts. Patients willingly donate data with clear information, showcasing the chatbot's potential as a nursing expert system. Expanding chat-based nurse counselling may enhance post-inpatient advice, necessitating future considerations for broader deployment.