Abstract Body (Do not enter title and authors here): Introduction: Smartphone applications increasingly are utilized to enhance patient education for optimal implementation of care plans to improve overall outcomes. We demonstrate the use of an app with instructions and built-in reminders for patients in the peri-operative phase of cardiothoracic surgery to reduce readmission rates and improve patient satisfaction.

Hypothesis: We postulated that patients undergoing cardiothoracic procedures who used a smartphone application pre and post-procedure would demonstrate improved outcomes compared to non-users, including reduced 90 day rates of hospital readmission, wound complications, or post-op thoracentesis, as well as demonstrate enhanced patient satisfaction.

Methods: We prospectively enrolled patients in the pre-operative phase undergoing cardiothoracic procedures including coronary artery bypass graft (CABG), valvular replacement, or patent foramen ovale closure, who either downloaded or declined the app. Patients were tracked for successful registration and use of the app. Post-operative outcomes including readmissions, wound complications, and need for thoracentesis were tracked for 90 days. Patients were also administered an in-person satisfaction survey at 14 days post-op with responses recorded.

Results: App users (n=392) and non-users (n=334) with median age 67 years underwent cardiothoracic surgery between May 29, 2023 and February 2, 2024. Among app users, 23 experienced 90-day readmission compared to 49 non-users (5.9% vs 14.7%, p=<0.0001). Subsequent results are similarly sequenced. No difference was observed between wound complications (3.83% vs 3.29%, p=0.700) or post-op thoracentesis (3.1% vs 1.9%, p=0.275). App users reported increased satisfaction on a five-point scale with preparation for surgery (4.9 vs 4.5, p=0.0031), surgeon communication post-op (5.0 vs 4.9, p=0.0033), preparation for recovery (4.8 vs 4.5, p=0.0291), and overall experience (5.0 vs 4.8, p=0.0130).

Conclusion: We demonstrated smartphone application catalyzed patient engagement throughout peri-operative experience of cardiothoracic surgery resulted in significantly reduced 90-day readmissions and improved patient satisfaction. Extension of app usage to similar clinical contexts may lead to like outcomes.