Author: Megan Rolfzen, MD
The Daily Dose
Digital technology is expanding perioperative medicine beyond the operating room and into patients’ homes. At the 2026 IARS and SOCCA Annual Meeting, an expert panel examined how teleconsultation, virtual hospital wards, wearable monitoring, and postoperative virtual care may help anesthesiologists oversee patients throughout the entire surgical experience.
The session described postoperative care as a potential “fourth branch” of anesthesia, joining the traditional responsibilities of preoperative assessment, intraoperative care, and pain management. As hospital stays become shorter, anesthesiologists may assume a greater role in identifying and managing complications after discharge.
Virtual preoperative assessments
David MacDonald, MD, FRCPC, discussed the rapid expansion of virtual preoperative evaluations. Before the COVID-19 pandemic, telemedicine represented only a small percentage of physician visits in Canada, but its use increased dramatically during and after the pandemic.
The TELANESTH randomized controlled trial compared virtual anesthesia consultations with traditional face-to-face visits. The study found no significant differences in surgical cancellation rates or immediate perioperative complications.
Virtual consultations may provide important advantages for patients, including reduced travel, lower expenses, less time away from work, and decreased stress. They may be particularly beneficial for patients who live far from major medical centers or have mobility limitations.
The ongoing VIRTUAL study is examining whether virtual preoperative pathways affect more significant outcomes, including morbidity and mortality during the 90 days following surgery.
Virtual wards and continuous monitoring
David Brealey, MD, addressed limitations in traditional hospital ward monitoring. In many healthcare systems, vital signs are recorded only a few times each day. This can allow early signs of deterioration to go unnoticed between routine nursing assessments.
Virtual wards use wearable devices to continuously monitor patients while they remain on a regular hospital ward or recover at home. One example is the CPC12S wearable monitor, which continuously measures heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature.
Continuous monitoring could allow healthcare teams to identify deterioration sooner than traditional intermittent observations. However, introducing these technologies into complex hospital systems presents major challenges.
Devices must be accurate, reliable, easy to use, and capable of integrating with existing medical records and clinical workflows. Healthcare organizations must also determine who reviews the information, how frequently it is reviewed, and what actions should be taken when abnormal findings occur.
Dr. Brealey cautioned that stronger clinical evidence is required before wearable monitoring can move beyond technological enthusiasm and become a routine part of high-acuity patient care.
Postoperative virtual care at home
Sylvie Aucoin, MD, MSc, FRCPC, discussed Postoperative Virtual Care and Remote Automated Monitoring, known as PVC-RAM.
As patients are discharged earlier after surgery, more complications are occurring outside the hospital. The PVC-RAM model attempts to close this gap by combining daily electronic surveys, wound photographs, virtual nursing visits, and remote monitoring of vital signs.
The intensity and duration of monitoring can be adjusted according to the patient’s procedure and risk level. A lower-risk gynecology patient might receive three days of follow-up, while a patient recovering from a lobectomy or cystectomy might receive a monitoring kit and ten days of intensive virtual care.
Patients have generally responded positively to these programs. Even many patients older than 65 have found the technology easy to use and have appreciated having immediate access to clinical support.
Successful virtual care programs require cooperation among anesthesiologists, surgeons, nurses, hospital administrators, information technology teams, paramedics, and home healthcare providers. Virtual nurses also require specialized education so they can interpret remotely collected information and respond appropriately.
Clinical significance
Teleconsultation can make preoperative assessments more convenient without appearing to increase cancellations or immediate complications. Continuous wearable monitoring may identify clinical deterioration earlier, while postoperative virtual care can extend hospital-level observation into the patient’s home.
However, technology alone will not improve outcomes. These programs require reliable devices, clearly defined clinical responsibilities, effective communication, appropriate patient selection, and strong administrative support.
Additional research is needed to determine whether these innovations reduce major complications, readmissions, morbidity, mortality, and healthcare costs.
As perioperative care continues to evolve, anesthesiologists may increasingly serve as guardians of patient recovery before, during, and after hospitalization. Virtual care offers a promising way to maintain close clinical oversight even after patients leave the operating room or hospital.
Thank you to The Daily Dose and IARS for allowing us to summarize this important discussion of virtual innovation in perioperative medicine.