TY - JOUR T1 - Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM): protocol for a randomized controlled trial JF - CMAJ Open JO - CMAJ SP - E142 LP - E148 DO - 10.9778/cmajo.20200176 VL - 9 IS - 1 AU - Michael H. McGillion AU - Joel Parlow AU - Flavia K. Borges AU - Maura Marcucci AU - Michael Jacka AU - Anthony Adili AU - Manoj M. Lalu AU - Homer Yang AU - Ameen Patel AU - Susan O’Leary AU - Vikas Tandon AU - Gavin M. Hamilton AU - Marko Mrkobrada AU - Carley Ouellette AU - Marissa Bird AU - Sandra Ofori AU - David Conen AU - Pavel S. Roshanov AU - Valerie Harvey AU - Gordon H. Guyatt AU - Yannick Le Manach AU - Shrikant I. Bangdiwala AU - Ramiro Arellano AU - Ted Scott AU - Jennifer Lounsbury AU - Dylan A. Taylor AU - Rahima Nenshi AU - Alan J. Forster AU - Mahesh Nagappa AU - Andre Lamy AU - Elizabeth Peter AU - Kelsea Levesque AU - Kristen Marosi AU - Sultan Chaudhry AU - Shariq Haider AU - Lesly Deuchar AU - Brandi LeBlanc AU - Colin J.L. McCartney AU - Emil H. Schemitsch AU - Jessica Vincent AU - Shirley M. Pettit AU - James Paul AU - Deborah DuMerton AU - Angela Djuric Paulin AU - Marko Simunovic AU - David C. Williams AU - Samantha Halman AU - Christopher M. Schlachta AU - Jessica Shelley AU - John Harlock AU - Ralph M. Meyer AU - Michelle Graham AU - Harsha Shanthanna AU - Neil Parry AU - David R. Pichora AU - Haroon Yousef AU - Husein Moloo AU - Herman Sehmbi AU - Melissa Waggott AU - Emilie P. Belley-Cote AU - Richard Whitlock AU - P.J. Devereaux A2 - , Y1 - 2021/01/01 UR - http://www.cmajopen.ca/content/9/1/E142.abstract N2 - Background: After nonelective (i.e., semiurgent, urgent and emergent) surgeries, patients discharged from hospitals are at risk of readmissions, emergency department visits or death. During the coronavirus disease 2019 (COVID-19) pandemic, we are undertaking the Post Discharge after Surgery Virtual Care with Remote Automated Monitoring Technology (PVC-RAM) trial to determine if virtual care with remote automated monitoring (RAM) compared with standard care will increase the number of days adult patients remain alive at home after being discharged following nonelective surgery.Methods: We are conducting a randomized controlled trial in which 900 adults who are being discharged after nonelective surgery from 8 Canadian hospitals are randomly assigned to receive virtual care with RAM or standard care. Outcome adjudicators are masked to group allocations. Patients in the experimental group learn how to use the study’s tablet computer and RAM technology, which will measure their vital signs. For 30 days, patients take daily biophysical measurements and complete a recovery survey. Patients interact with nurses via the cellular modem–enabled tablet, who escalate care to preassigned and available physicians if RAM measurements exceed predetermined thresholds, patients report symptoms, a medication error is identified or the nurses have concerns they cannot resolve. The primary outcome is number of days alive at home during the 30 days after randomization.Interpretation: This trial will inform management of patients after discharge following surgery in the COVID-19 pandemic and offer insights for management of patients who undergo nonelective surgery in a nonpandemic setting. Knowledge dissemination will be supported through an online multimedia resource centre, policy briefs, presentations, peer-reviewed journal publications and media engagement. Trial registration: ClinicalTrials.gov, no. NCT04344665 ER -